Community-based art groups in mental health recovery: A systematic review and narrative synthesis

INTRODUCTION

Though the evidence of the role of the arts in mental health is growing, no systematic review has focused on the impact of art groups in non-clinical settings in the process of recovery following the CHIME framework.

AIM

The aim of this study was to examine the effects of engaging in community-based art groups in mental health recovery.

METHOD

A search in five electronic databases for relevant research using quantitative, qualitative or mixed methods published between 2000 and 2019 identified nine eligible studies.

RESULTS

While there was great methodological heterogeneity, most studies were qualitative, used visual arts, facilitated by artists and assessed by mental health nurses, and took place in community locations or artistic venues. Quantitative outcomes, though few, provided evidence of increased well-being, and qualitative outcomes corresponded mostly with the recovery process of Connectedness. Additional outcomes related to the settings were a sense of safety and to the intervention: self-expression, development of skills and achievements, and the impact of final exhibitions and peer leadership.

DISCUSSION

Studies should aim at prospective designs following mixed methods approaches, with larger and gender-sensitive samples, control groups and follow-up assessments, and evaluate cost-effectiveness.

IMPLICATIONS FOR PRACTICE

Community-based art groups which increase well-being and promote connectedness should be key in recovery-action planning.

Does Religious Priming Induce Greater Prejudice? A Meta-Analytic Review

The current meta-analysis addressed whether theistic religious beliefs are causally related to greater prejudice by analyzing 44 studies (Ntotal = 11,330) that used experimental designs-priming religion and then measuring negativity toward outgroups (e.g., LGBT and Muslim). The overall priming effect was significant but small (r = .06), indicating that priming religion increases prejudice. The implications of these results for the relation between religion and prejudice and for future work on religious priming are discussed.

Group Formation and the Evolution of Human Social Organization

Humans operate in groups that are oftentimes nested in multilayered collectives such as work units within departments and companies, neighborhoods within cities, and regions within nation states. With psychological science mostly focusing on proximate reasons for individuals to join existing groups and how existing groups function, we still poorly understand why groups form ex nihilo, how groups evolve into complex multilayered social structures, and what explains fission-fusion dynamics. Here we address group formation and the evolution of social organization at both the proximate and ultimate level of analysis. Building on models of fitness interdependence and cooperation, we propose that socioecologies can create positive interdependencies among strangers and pave the way for the formation of stable coalitions and groups through reciprocity and reputation-based partner selection. Such groups are marked by in-group bounded, parochial cooperation together with an array of social institutions for managing the commons, allowing groups to scale in size and complexity while avoiding the breakdown of cooperation. Our analysis reveals how distinct group cultures can endogenously emerge from reciprocal cooperation, shows that social identification and group commitment are likely consequences rather than causes of group cooperation, and explains when intergroup relations gravitate toward peaceful coexistence, integration, or conflict.

Behind the Blackpill: Self-Verification and Identity Fusion Predict Endorsement of Violence Against Women Among Self-Identified Incels

Incels (involuntary celibates) have advocated for and even enacted violence against women. We explored two mechanisms that may underly incels' actions: identity fusion and self-verification. Study 1 (n = 155) revealed stronger identity fusion (deep alignment) with the ingroup among men active in online incel communities compared to men active in other male-dominated groups. Study 2 (n = 113) showed that feeling self-verified by other incels predicted fusion with incels; fusion, in turn, predicted endorsement of past and future violence toward women. Study 3 (n = 283; preregistered) replicated the indirect effects from Study 2 and extended them by linking fusion to online harassment of women. All indirect effects were particularly strong among self-identified incels high in narcissism. We discuss the synergistic links between self-verification and identity fusion in fostering extreme behaviors and identify directions for future research.

The Psychology of Athletic Endeavor

A considerable amount of human behavior occurs within the context of sports. In recent years there have been notable advances in psychological science research applied to understanding athletic endeavor. This work has utilized a number of novel theoretical, methodological, and data analytic approaches. We review the current evidence related to developmental considerations, intrapersonal athlete factors, group processes, and the role of the coach in explaining how athletes function within the sport domain. This body of work sheds light on the diverse ways in which psychological processes contribute to athletic strivings. It also has the potential to spark interest in domains of psychology concerned with achievement as well as to encourage cross-domain fertilization of ideas.

Exploring the social dynamics of urban regeneration: A qualitative analysis of community members' experiences

The present paper explores psychological processes that underpin the success of community change in the context of urban regeneration schemes. We adopt a social identity approach to develop an understanding of the ways in which social identity dynamics may impact upon peoples' experiences of regeneration, and what influence these identity processes have on the creation of new communities. Qualitative interviews, using thematic analysis as an analytic technique, were conducted with community members (n = 14) in a recently (2001-2011) regenerated area in the South-West of England. Three overarching themes were identified: Patterns of identification, willingness to engage, and the notion of regeneration as an event. The research overall highlights the central role of group-based identity in understanding the processes of regeneration and how this is experienced by different community members. Findings are discussed in relation to the impact regeneration schemes have on community members' sense of collective self, unity, and engagement. The research highlights the pivotal role of social identity processes in delivering successful and sustainable strategies of urban regeneration.

Insights From the Virtual Team Science: Rapid Deployment During COVID-19

OBJECTIVE

To provide insights for organizations that must rapidly deploy teams to remote work.

BACKGROUND

Modern situations, such as the COVID-19 pandemic, are rapidly accelerating the need for organizations to move employee teams to virtual environments, sometimes with little to no opportunities to prepare for the transition. It is likely that organizations will continually have to adapt to evolving conditions in the future.

METHOD

This review synthesizes the literature from several sources on best practices, lessons learned, and strategies for virtual teams. Information from each article deemed relevant was then extracted and de-identified. Over 64 best practices were independently and blindly coded for relevancy for the swift deployment of virtual teams.

RESULTS

As a result of this review, tips for virtual teams undergoing rapid transition to remote work were developed. These tips are organized at the organization, team, and individual levels. They are further categorized under six overarching themes: norm setting, performance monitoring, leadership, supportive mechanisms, communication, and flexibility.

CONCLUSION

There is a significant deficit in the literature for best practices for virtual teams for the purposes of rapid deployment, leaving it to organizations to subjectively determine what advice to adhere to. This manuscript synthesizes relevant practices and provides insights into effective virtual team rapid deployment.

Exposure to incivility does not hinder speaking up: a randomised controlled high-fidelity simulation-based study

BACKGROUND

Speaking up with concerns is critical for patient safety. We studied whether witnessing a civil (i.e. polite, respectful) response to speaking up would increase the occurrence of further speaking up by hospital staff members as compared with witnessing a pseudo-civil (i.e. vague and slightly dismissive) or rude response.

METHODS

In this RCT in a single, large academic teaching hospital, a single simulated basic life support scenario was designed to elicit standardised opportunities to speak up. Participants in teams of two or three were randomly assigned to one of three experimental conditions in which the degree of civility in reacting to speaking up was manipulated by an embedded simulated person. Speaking up behaviour was assessed by behaviour coding of the video recordings of the team interactions by applying 10 codes using The Observer XT 14.1. Data were analysed using multilevel modelling.

RESULTS

The sample included 125 interprofessional hospital staff members (82 [66%] women, 43 [34%] men). Participants were more likely to speak up when they felt psychologically safe (γ=0.47; standard error [se]=0.19; 95% confidence interval [CI], 0.09-0.85; P=0.017). Participants were more likely to speak up in the rude condition than in the other conditions (γ=0.28; se=0.12; 95% CI, 0.05-0.52; P=0.019). Across conditions, participants spoke up most frequently by structuring inquiry (n=289, 31.52%), proactive (n=240, 26.17%), and reactive (n=148, 16.14%) instruction statements, and gestures (n=139, 15.16%).

CONCLUSION

Our study challenges current assumptions about the interplay of civility and speaking up behaviour in healthcare.

Tracking group identity through natural language within groups

To what degree can we determine people's connections with groups through the language they use? In recent years, large archives of behavioral data from social media communities have become available to social scientists, opening the possibility of tracking naturally occurring group identity processes. A feature of most digital groups is that they rely exclusively on the written word. Across 3 studies, we developed and validated a language-based metric of group identity strength and demonstrated its potential in tracking identity processes in online communities. In Studies 1a-1c, 873 people wrote about their connections to various groups (country, college, or religion). A total of 2 language markers of group identity strength were found: high affiliation (more words like we, togetherness) and low cognitive processing or questioning (fewer words like think, unsure). Using these markers, a language-based unquestioning affiliation index was developed and applied to in-class stream-of-consciousness essays of 2,161 college students (Study 2). Greater levels of unquestioning affiliation expressed in language predicted not only self-reported university identity but also students' likelihood of remaining enrolled in college a year later. In Study 3, the index was applied to naturalistic Reddit conversations of 270,784 people in 2 online communities of supporters of the 2016 presidential candidates-Hillary Clinton and Donald Trump. The index predicted how long people would remain in the group (3a) and revealed temporal shifts mirroring members' joining and leaving of groups (3b). Together, the studies highlight the promise of a language-based approach for tracking and studying group identity processes in online groups.

Mirroring, monitoring, modelling, belonging, and distancing: Psychosocial processes in an online support group of breast cancer patients

Breast cancer patients are primary users of Internet Health Forums, virtual self-help communities where they find and share information, preoccupations, and support. Previous literature has mainly focused on analysing the contents and the outcomes of breast cancer forums' participation. In light of the Community of Practice theoretical model, our research investigated the psychosocial processes that build and shape patients' experience and participation in the forum. We conducted 16 semi-structured email interviews with breast cancer patients recruited within a well-established online community. Thematic analysis identified five processes-mirroring, monitoring, modelling, belonging, and distancing-that marked three phases of users' experience: initiation, participation, detachment. An interactive dynamic characterised the identified processes: the disease's experience was shaped by and, in turn, it crafted this virtual community. These community processes contributed to participants' empowerment at practical, informative, and emotional levels through the development of a shared repertoire of resources, stories, and ways of dealing with patients' recurring problems.

Beyond Observation: Manipulating Circumstances to Detect Affordances and Infer Traits

Social perceivers seek to understand the opportunities and threats others potentially afford-for example, whether a teammate will behave tenaciously or a romantic partner, faithfully. We typically detect affordances and draw trait inferences by observing behaviors that reveal or predict others' likely intentions and characteristics. However, detection and inference from simple observation are often difficult (e.g., even dishonest people are frequently honest, people often mask unpopular beliefs). In such cases, we propose that people test, actively manipulating others' circumstances to reveal hard-to-observe affordances and characteristics. The Observation-Testing Model is a framework predicting circumstances under which testing is more likely to happen, which affordances and characteristics are more likely to be tested for, and which people are more likely to test and be tested. We identify preliminary support for the model from a range of literatures (e.g., employment assessment, coming-of-age rituals, dating processes) and identify areas needing further research.

The Safer Culture Framework: An Application to Healthcare Based on a Multi-Industry Review of Safety Culture Literature

BACKGROUND

Errors and preventable harm to patients remain regrettably common and expensive in healthcare. Improvement requires transforming the culture of the healthcare industry to put a greater emphasis on safety. Safety culture involves holding collective attitudes, values, and behaviors that prioritize safety. The Safer Culture framework, previously established through a narrative review of literature in multiple industries, provides a consensus on what impacts safety culture, how it manifests in behavior, and how it influences safety-related outcomes.

METHODS

Through a theoretical review, we validate, refine, and provide nuance to this framework for the development of safety culture in healthcare contexts. To accomplish this, we conceptually map existing dimensions pulled through the literature onto our Safer Culture framework.

RESULTS

A total of 360 articles were reviewed. We present specific elements for each dimension in our framework and apply the dimension to healthcare contexts.

CONCLUSION

We provide an evidence-based and comprehensive framework that can be used by patient safety leaders and researchers to guide the evaluation of safety culture and develop interventions to foster patient safety culture and improve patient safety outcomes.

Diversity's Impact on the Quality of Deliberations

The present research builds on previous models of jury diversity's benefits by exploring how diversity impacts the deliberation process. In Study 1, community members (N = 433) participated in a jury decision-making study manipulating the strength of evidence (ambiguous vs. weak) and the diversity of the jury. When the evidence in the case was ambiguous, both white and black jurors made high-quality contributions to discussion in diverse juries than in nondiverse juries. In Study 2, undergraduate students (N = 369) were randomly assigned to wealth and power conditions and then deliberated in diverse and nondiverse groups. Diverse juries were less likely to convict the defendant, and jurors on diverse juries made high-quality contributions to discussion. Although previous work has documented effects of diversity on high-status jurors' contributions to deliberations, this work suggests that diversity may relate to more complex evidence evaluation for members of low-status groups as well.

Associations of form and function of speaking up in anaesthesia: a prospective observational study

BACKGROUND

Speaking up with concerns in the interest of patient safety has been identified as important for the quality and safety of patient care. The study objectives were to identify how anaesthesia care providers speak up, how their colleagues react to it, whether there is an association among speak up form and reaction, and how this reaction is associated with further speak up.

METHODS

Data were collected over 3 months at a single centre in Switzerland by observing 49 anaesthesia care providers while performing induction of general anaesthesia in 53 anaesthesia teams. Speaking up and reactions to speaking up were measured by event-based behaviour coding.

RESULTS

Instances of speaking up were classified as opinion (59.6%), oblique hint (37.2%), inquiry (30.7%), and observation (16.7%). Most speak up occurred as a combination of different forms. Reactions to speak up included short approval (36.5%), elaboration (35.9%), no verbal reaction (26.3%), or rejection (1.28%). Speaking up was implemented in 89.1% of cases. Inquiry was associated with an increased likelihood of recipients discussing the respective issue (odds ratio [OR]=13.6; 95% confidence interval [CI], 5.9-31.5; P<0.0001) and with a decreased likelihood of implementing the speak up during the same induction (OR=0.27; 95% CI, 0.08-0.88; P=0.03). Reacting with elaboration to the first speak up was associated with decreased further speak up during the same induction (relative risk [RR]=0.42; 95% CI, 0.21-0.83; P=0.018).

CONCLUSION

Our study provides insights into the form and function of speaking up in clinical environments and points to a perceived dilemma of speaking up via questions.

Huddles and their effectiveness at the frontlines of clinical care: a scoping review

BACKGROUND

Brief, stand-up meetings known as huddles may improve clinical care, but knowledge about huddle implementation and effectiveness at the frontlines is fragmented and setting specific. This work provides a comprehensive overview of huddles used in diverse health care settings, examines the empirical support for huddle effectiveness, and identifies knowledge gaps and opportunities for future research.

METHODS

A scoping review was completed by searching the databases PubMed, EBSCOhost, ProQuest, and OvidSP for studies published in English from inception to May 31, 2019. Eligible studies described huddles that (1) took place in a clinical or medical setting providing health care patient services, (2) included frontline staff members, (3) were used to improve care quality, and (4) were studied empirically. Two reviewers independently screened abstracts and full texts; seven reviewers independently abstracted data from full texts.

RESULTS

Of 2,185 identified studies, 158 met inclusion criteria. The majority (67.7%) of studies described huddles used to improve team communication, collaboration, and/or coordination. Huddles positively impacted team process outcomes in 67.7% of studies, including improvements in efficiency, process-based functioning, and communication across clinical roles (64.4%); situational awareness and staff perceptions of safety and safety climate (44.6%); and staff satisfaction and engagement (29.7%). Almost half of studies (44.3%) reported huddles positively impacting clinical care outcomes such as patients receiving timely and/or evidence-based assessments and care (31.4%); decreased medical errors and adverse drug events (24.3%); and decreased rates of other negative outcomes (20.0%).

DISCUSSION

Huddles involving frontline staff are an increasingly prevalent practice across diverse health care settings. Huddles are generally interdisciplinary and aimed at improving team communication, collaboration, and/or coordination. Data from the scoping review point to the effectiveness of huddles at improving work and team process outcomes and indicate the positive impact of huddles can extend beyond processes to include improvements in clinical outcomes.

STUDY REGISTRATION

This scoping review was registered with the Open Science Framework on 18 January 2019 ( https://osf.io/bdj2x/ ).

"Here we are together, at home you are alone" - social interactions and personal engagement during a group-based rehabilitation program for young adults with disability

PURPOSE

Young adults with disabilities often report feeling alone in their experience of disability. Group-based rehabilitation programs provide opportunities to participate in learning processes and share experiences of living with a disability. The aim of this study was to explore and interpret social interactions and personal processes of engagement and development of young adults with disabilities during a rehabilitation program.

METHODS

Fifty-four young adults attending a group-based rehabilitation program at Beitostølen Healthsports Center (BHC) participated in the study. A grounded theory methodology employing ethnographic data enabled an in-depth exploration of the social processes occurring during the rehabilitation stay.

RESULTS

The social environment was important to personal processes during the stay. Fundamental to the social processes was a culture defined by opportunities, competence, and involvement of the young adults that promoted feelings of safety and the freedom to challenge themselves. Being with peers with disabilities enabled a sense of community underpinned by a shared understanding. Peers fostered motivation to actively engage in the participation processes, built courage and promoted self-reflection.

CONCLUSION

This article contributes to the understanding of the dynamic interactions between social contextual structures and interrelations, and personal processes of engagement and developmental experiences during a group-based rehabilitation program.IMPLICATIONs FOR REHABILITATIONRehabilitation in context of a peer-group was highly valued and made a unique contribution to the rehabilitation experience.Being in a group with peers sharing the experience of disability resulted in a safe learning environment, improving participants' motivation, encouraging them to engage in challenging activities and social interactions.The informal interactions and shared experience of living with a disability promoted self-reflection and improved self-understanding.Being with peers sharing the experience of disability provided opportunities for role modelling and mentoring, inspiring participants as to what might be possible.

Patient representatives: Crucial members of health-care working groups facing an uncertain role and conflicting expectations. A qualitative study

BACKGROUND

Patient representatives (PRs) have been involved for decades in health-care development, and their participation is increasingly sought in health-care working groups (HCWGs) on every level. However, information on how the role could be further developed and teamwork improved remains sparse.

OBJECTIVE

To explore the role of patient representatives in clinical practice guideline (CPG) monitoring groups, to describe their contributions and identify possibilities of improvement.

DESIGN

Qualitative design using semi-structured interviews analysed by content analysis.

SETTING AND PARTICIPANTS

Interviews were conducted with 11 PRs, 13 registered nurses, and 9 physicians, all members of national committees monitoring CPGs for cancer in Sweden.

RESULTS

Most participants considered the PR role important but mentioned several problems. PRs' contributions were hampered by uncertainties about their role, the low expectations of other group members and their sense that their contributions were often disregarded. Some professionals questioned whether PRs were truly representative and said some topics could not be discussed with PRs present.

CONCLUSION

This study highlights the fundamental problems that remain to be solved despite the long involvement of PRs in HCWGs. Even though the PR role and teamwork differed between the groups, most PRs need to be empowered to be actively involved in the teamwork and have their engagement and knowledge fully utilized. Enhancing teamwork through clarifying roles and expectations could lead to more inclusive and equal teams able to work more effectively towards the goal of improving health care.

PATIENT OR PUBLIC CONTRIBUTION

PRs were information givers in data collection.

The Development of Identity Fusion

The fusion of personal and group identities can lead to self-sacrificial progroup behavior, from acts of charity to violent extremism. Two pathways to identity fusion-via shared biology and shared experiences-have been proposed. In this article, we elucidate a new developmental account of the origins and mechanisms of these two pathways to identity fusion from childhood to adulthood. Whereas fusion based on shared biology occurs from early childhood cued by phenotypic similarity, fusion based on episodic memories of shared experiences is not possible until midadolescence and relies on suitable bonding experiences (e.g., painful initiation rituals, emotionally intense team sports). The critical development that enables fusion based on shared experiences is autobiographical reasoning, which entails connecting one's past experiences to the present self. Autobiographical reasoning begins in adolescence, which may explain the flourishing of fusion in late adolescence and young adulthood relative to other life periods. Fusion via either pathway is linked to strong progroup behavior. We outline a program of empirical research on the development of identity fusion while addressing relevant methodological challenges. A developmental framework may help foster efforts to harness identity fusion for peaceful rather than violent forms of self-sacrifice for the group.

Team Physiological Dynamics: A Critical Review

OBJECTIVE

Review the use of physiological measurement in team settings and propose recommendations to improve the state of the science.

BACKGROUND

New sensor and analytical capabilities enable exploration of relationships between team members' physiological dynamics. We conducted a review of physiological measures used in research on teams to understand (1) how these measures are theoretically and operationally related to team constructs and (2) what types of validity evidence exist for physiological measurement in team settings.

METHOD

We identified 32 articles that investigated task-performing teams using physiological data. Articles were coded on several dimensions, including team characteristics. Study findings were categorized by relationships tested between team physiological dynamics (TPD) and team inputs, mediators/processes, outputs, or psychometric properties.

RESULTS

TPD researchers overwhelmingly measure single physiological systems. Although there is research linking TPD to inputs and outputs, the research on processes is underdeveloped.

CONCLUSION

We recommend several theoretical, methodological, and statistical themes to expand the growth of the TPD field.

APPLICATION

Physiological measures, once established as reliable indicators of team functioning, might be used to diagnose suboptimal team states and cue interventions to ameliorate these states.

The therapeutic group in adolescence: A process of intersubjectivation

This article analyses group processes in adolescence through therapeutic group interventions. The authors propose to analyse the group aspect, cross-identifications and projective identifications of the adolescent subjectivation process. In which ways does the adolescent subjectivation process need to go through a process of intersubjectivation? This involves a consideration of observable intersubjectivity in a therapeutic group with troubled adolescents. After redefining the notion of subjectivation process and its various manifestations in adolescent psychopathology, the authors further analyse the complex implications of this notion, from the point of view of object cathexes and of links to others. The task is to establish a metapsychology of links to introduce therapeutic psychoanalytic groups into psychic dynamics: in particular, the authors discuss the methodology of theatre-mediated therapeutic psychoanalytic groups, from which the clinical vignette discussed is taken. A case study of a group of adolescents discovers the haphazardness of the link to the other, as a cornerstone towards reinitializing the process of subjectivation that has been hindered in members of the group, and as a way of resuming self-reflectiveness and the reimagining of the self.

Architecture, urban planning and collective identity: Bilbao as a case study

The emergence of a collective identity, a complex social and psychological process, may be linked to a specific place and a particular urban layout. Architecture demarcates interior and exterior spaces that not only frame our relationships but can also generate a mirror image of the internal world. The authors examine relevant contributions from the sparse psychoanalytic literature on this subject, to support their hypothesis that changes to a city's landscape, design, or architecture, when wholeheartedly embraced by its citizens, can serve to forge a new collective identity that helps to deal with absence, pain, and loss. They present the city of Bilbao, Spain, as a case study. This once thriving industrial city had collapsed into economic ruin, rife with social conflict, but since the 1990s, in an urban renewal, has emerged as a unique tourist destination. It has become a modern art and cultural center, symbolized by its most famous piece of contemporary architecture.

Collaboration behaviors within interactive exercise groups

OBJECTIVE

The purpose of this study was to gain a better understanding of collaboration behaviors within interactive exercise groups.

DESIGN

Qualitative study.

MAIN OUTCOME MEASURES

Using semi-structured interviews, 16 individuals who exercise in small groups (e.g., workout partners, participants of interactive fitness classes) were recruited to (a) reflect on their experiences of collaboration within this context, and (b) identify behaviors that members demonstrate that help each other perform exercise tasks and achieve their exercise-related goals. Data were analyzed using thematic analysis.

RESULTS

We identified three overarching themes (and 14 subthemes) reflecting participants' perceptions and experiences of collaboration in exercise groups including 'motivation building', 'intragroup coaching', and 'personal support'. These collaboration behaviors were noted by participants as important in shaping their continued exercise adherence, enjoyment, and relatedness.

CONCLUSION

This study advances knowledge of the specific ways in which individuals can work together effectively within interactive exercise groups and provides a novel means of understanding how the group environment might best be leveraged to support exercise behavior.

A gentle reminder that mean does not imply modal behavior: Few are in-group biased in minimal groups

Previous research reports that people organized into newly formed, arbitrary groups (i.e., minimal groups) are on average in-group biased. However, that people on average behave in a certain way does not imply that most people behave that way. Here, I report four studies (n = 224) demonstrating in-group biased average behaviors driven by a minority of about 30% participants. Further, only 14% reported allocating resources in a group-biased manner because they "favored the in-group." I investigate and discuss how methodological issues related to non-normally distributed data, not taking participants' intentions into account, and using fixed response matrices can lead to overestimations of how widespread in-group bias is in minimal groups.

A social identity perspective on COVID-19: Health risk is affected by shared group membership

In the face of a novel infectious disease, changing our collective behaviour is critical to saving lives. One determinant of risk perception and risk behaviour that is often overlooked is the degree to which we share psychological group membership with others. We outline, and summarize supporting evidence for, a theoretical model that articulates the role of shared group membership in attenuating health risk perception and increasing health risk behaviour. We emphasize the importance of attending to these processes in the context of the ongoing response to COVID‐19 and conclude with three recommendations for how group processes can be harnessed to improve this response.

Ethics Versus Success? The Acceptance of Unethical Leadership in the 2016 US Presidential Elections

Before and after the 2016 US Presidential Election, this research examined Trump and Clinton supporters’ attributions about behavior of each leader, both of whose ethicality had been publicly questioned. American voters (N = 268) attributed significantly more dispositional factors to the outgroup leader than to the ingroup leader. Moreover, when the ingroup candidate won the election (i.e., among Trump supporters), unethical leadership subsequently became more acceptable and there was less desire to tighten the election process when dealing with unethical candidates. The opposite pattern was found among voters whose ingroup candidate lost the election (Clinton supporters). The results and implications are discussed.

The contribution of group work to the goals of comprehensive primary health care

ISSUE ADDRESSED

Group work, such as peer support and health promotion is an important strategy available to comprehensive primary health care. However, group work and how it contributes to the goals of comprehensive primary health care has been under-researched and under-theorised.

METHODS

In this 5-year study, we partnered with seven Australian primary health care services, and drew on service reports, two rounds of staff interviews (2009-2010 and 2013, N = 68 and 55), 10 community assessment workshops (N = 65), a client survey (N = 315) and case tracking of clients with diabetes (N = 184, plus interviews with 35 clients, and five practitioners) and clients with depression (N = 95, plus interviews with 21 clients, and 11 practitioners). We conducted a rapid literature review of existing research on group work, and developed a model showing a group work reinforcing cycle. We examined the nature of the groups run, and the benefits staff and clients perceived.

RESULTS

Benefits were grouped into four main themes: (a) social support, including for clients of the Aboriginal services, opportunities to celebrate their cultural identity, (b) improving skills and knowledge, (c) increasing access to services and (d) empowerment and solidarity.

CONCLUSIONS

The perceived collective and individual benefits aligned with a comprehensive primary health care vision. However, the individualism stressed by neoliberal-driven health policy threatened the provision of group work and its potential collectivist benefits.

SO WHAT

There are multiple benefits of group work in primary health care that cannot be achieved through individual work, highlighting the importance of policy and organisational support for group work.

Systematic Review and Meta-Analysis of Self-Serving Attribution Biases in the Competitive Context of Organized Sport

This meta-analysis explored the magnitude of self-serving attribution biases for real-world athletic outcomes. A comprehensive literature search identified 69 studies (160 effect sizes; 10,515 athletes) that were eligible for inclusion. Inverse-variance weighted random-effects meta-analysis showed that sport performers have a tendency to attribute personal success to internal factors and personal failure to external factors (k = 40, standardized mean difference [SMD] = 0.62), a tendency to attribute team success to factors within the team and team failure to factors outside the team (k = 23, SMD = 0.63), and a tendency to claim more personal responsibility for team success and less personal responsibility for team failure (k = 4, SMD = 0.28). There was some publication bias and heterogeneity in computed averages. Random effects meta-regression identified sample sex, performance level, and world-region as important moderators of pooled mean effects. These findings provide a foundation for theoretical development of self-serving tendencies in real-world settings.

Evidence for the reproduction of social class in brief speech

Economic inequality is at its highest point on record and is linked to poorer health and well-being across countries. The forces that perpetuate inequality continue to be studied, and here we examine how a person's position within the economic hierarchy, their social class, is accurately perceived and reproduced by mundane patterns embedded in brief speech. Studies 1 through 4 examined the extent that people accurately perceive social class based on brief speech patterns. We find that brief speech spoken out of context is sufficient to allow respondents to discern the social class of speakers at levels above chance accuracy, that adherence to both digital and subjective standards for English is associated with higher perceived and actual social class of speakers, and that pronunciation cues in speech communicate social class over and above speech content. In study 5, we find that people with prior hiring experience use speech patterns in preinterview conversations to judge the fit, competence, starting salary, and signing bonus of prospective job candidates in ways that bias the process in favor of applicants of higher social class. Overall, this research provides evidence for the stratification of common speech and its role in both shaping perceiver judgments and perpetuating inequality during the briefest interactions.

Exploring group boundaries and conflicts: a social identity theory perspective

CONTEXT

In the clinical environment, health care professionals self-categorise into different groups towards which they develop positive attitudes, whereas they view other groups less favourably. Social identity theory purports that these attitudes influence group processes and may foster conflicts that impede collaborative practice, although this relationship is poorly understood. This study used concepts from social identity theory to examine the interplay between group processes and conflicts, as well as the consequences of these conflicts, with the goal of identifying educational strategies to favour teamwork.

METHODS

Semi-structured interviews with 82 randomly selected physicians and nursing professionals working at a Swiss academic medical centre explored participants' experiences of conflicts. Data analysis was informed by social identity theory and focused on interviews where group processes were highlighted by participants. The analysis sought to uncover how group processes were intertwined with conflicts and how they affected health care professionals.

RESULTS

A total of 42 participants out of the initial pool of 82 interviews shared 52 stories of conflicts involving group processes. Most of these stories were shared by physicians and involved groups of physicians at different hierarchical levels. Conflicts and group processes were linked in two ways: (i) through processes of group membership when individuals struggled to join a relevant group, and (ii) through intergroup boundaries, such as when participants perceived that power differentials disadvantaged their own groups. Conflicts could lead to difficult experiences for clinicians who questioned their abilities, became disillusioned with their professional ideals and developed negative perceptions of other groups.

CONCLUSIONS

This study suggests that conflicts involving group processes may lead to stronger intergroup boundaries, challenging current educational efforts to favour teamwork in health care. Taking steps to create more inclusive groups and to encourage perspective taking may help manage intergroup conflict.

Key Factors to Consider in Team Meetings when Dealing with Multimorbidity in Primary Care: Results from a Delphi Panel

BACKGROUND

Multimorbidity brings several difficulties and challenges to the daily work of primary care teams. Team meetings are opportunities to discuss approaches and solutions on how to best manage multimorbid patients.

OBJECTIVE

This qualitative study aimed to collect a consensus, from general practitioners that deal with multimorbid patients, about their perspectives regarding multimorbidity team meetings in primary care.

METHODS

The study followed a modified Delphi method with 15 Portuguese general practitioners. After every round of responses, results were analyzed, and justifications for non-consensual items were aggregated by the investigators, and then a new Delphi round with the revised questionnaire was again initiated. This process was repeated until consensus has been reached.

RESULTS

Overall, a list of 10 key themes associated with the ideal meeting was agreed: (a) definition; (b) setting; (c) duration; (d) frequency; (e) number of participants; (f) attendance; (g) requirement of patient's presence; (h) number of patients/clinical cases; (i) structure of the meeting; and (j) sharing meeting results. The consensus was achieved after two Delphi rounds with a mean score between 7.9 and 8.7 (maximum score of 9.0 per key theme).

CONCLUSION

The complexity of multimorbidity affects meetings' periodicity, duration, and participants. Ideally, it should be an interprofessional primary care team meeting. Further research exploring meeting outcomes (organizational effectiveness and healthcare quality) of the proposed factors is needed before they can be recommended for general use.

I'll just watch: Do the pro-social effects of coordination really generalize to non-actors?

Moving in time together has been shown to cultivate pro-social effects in co-actors, such as cooperation and helping. But less is known about who these effects apply to - whether they are restricted only to co-actors, or whether they generalize to those not involved in the coordination. One difference between past work finding generalized vs. restricted effects is whether these "outsiders" were present for the coordination or not. The present study explores whether the pro-social effects of coordination are seen towards observers as well as co-actors, and whether the absence or presence of observers during the coordination is a determining factor. Results show that greater cooperation following coordination is only seen amongst co- actors, regardless of whether the observers were present during the task or not. Findings are discussed in the context of the literature and alternative explanations for research showing generalized effects are suggested.

Five (plus or minus one): The point at which an assemblage of individuals is perceived as a single, unified group

At what point is an assemblage of individuals perceived as a single, unified group? And how do demographic characteristics of these individuals influence perceptions of groupness? To answer these questions, we conducted four studies in which participants viewed sets of images that varied in the number of individuals depicted, and then identified the number of persons at which the assemblage was perceived to be a single, unified group. Across four studies, we manipulated the gender and race composition of the persons depicted. The results suggest that five (plus or minus one) people constitutes the point at which a collection of persons is perceived less like separate individuals and more like a single, unified group. However, the demographic complexity of the assemblage also influences perceived groupness. The number of individuals required to be perceived as a unified group is larger for diverse, compared to homogeneous, assemblages of individuals.

On Ladders and Pyramids: Hierarchy's Shape Determines Relationships and Performance in Groups

Hierarchies take different forms, which individuals mentally represent using different geometric shapes. We propose and empirically demonstrate that individuals' mental representations of the shape hierarchy takes affect its consequences. Five studies compared two common mental representations of hierarchy shapes-ladders and pyramids-to explore whether, why, and how individuals' perceptions of hierarchy's shape undermine constructive relationships within groups and group performance. Study 1 demonstrated that individuals commonly mentally represent hierarchies as ladders and pyramids. In Studies 2 and 3, employees who perceived their workplace hierarchies to be shaped like ladders (as compared with pyramids) experienced worse intragroup relationships. Finally, Studies 4 and 5 experimentally manipulated groups' hierarchical shape in the lab and found that ladder-shaped hierarchies undermined social relationships and group performance relative to pyramid-shaped hierarchies. Taken together, these findings enhance our understanding of hierarchies' multifaceted consequences and help shed light on the (dis)utility of hierarchy for group functioning.

Social psychological research on prejudice as collective action supporting emergent ingroup members

Why does social psychological research on prejudice change across time? We argue that scientific change is not simply a result of empirical evidence, technological developments, or social controversies, but rather emerges out of social change-driven shifts in how researchers categorize themselves and others within their larger societies. As mainstream researchers increasingly recategorize former outgroup members as part of a novel ingroup, prejudice research shifts in support of emergent ingroup members against their emergent outgroup opponents. Although social change-driven science results in valuable opportunities for researchers, it also results in significant risks for research - collective, scientific biases in the inclusion and exclusion of social groups in prejudice research that are not readily detected or managed by traditional controls. We present the Emergent Ingroup Model (EIM) to encourage reflection on shared biases, as well as to spark a broader conversation on how to strengthen our field for a rapidly changing and increasingly global world.

The Short and Longer Term Impacts of Hate Crimes Experienced Directly, Indirectly, and Through the Media

A longitudinal study ( N = 774) explored the short and longer term impacts of anti-Lesbian, Gay, Bisexual, and Trans (LGBT) hate crime experienced directly, indirectly, and through the media. In the short term, being a victim (direct) or personally knowing of a hate crime victim (indirect) was positively associated with vulnerability, emotional responses, and behavioral intentions after reading about a hate crime. Direct victims were also less empathic toward other victims and engaged in more victim-blaming. A structural equation model showed direct experiences (via personal vulnerability and empathy) and media experiences (via group-threat and victim-blaming) to be cross-sectionally associated with behavioral intentions. Media experiences also had lasting demobilizing impacts on actual behaviors, again serially mediated by group-threat and victim-blaming. The findings highlight the emotional and behavioral impacts of hate crimes on both direct victims and on the wider LGBT community. They also raise questions about media reporting of hate crimes and the role of victim-blaming.

Redundant Automation Monitoring: Four Eyes Don't See More Than Two, if Everyone Turns a Blind Eye

BACKGROUND

In safety-critical and highly automated environments, more than one person typically monitors the system in order to increase reliability.

OBJECTIVE

We investigate whether the anticipated advantage of redundant automation monitoring is lost due to social loafing and whether individual performance feedback can mitigate this effect.

METHOD

In two experiments, participants worked on a multitasking paradigm in which one task was the monitoring and cross-checking of an automation. Participants worked either alone or with a team partner on this task. The redundant group was further subdivided. One subgroup was instructed that only team performance would be evaluated, whereas the other subgroup expected to receive individual performance feedback after the experiment.

RESULTS

Compared to participants working alone, those who worked collectively but did not expect individual feedback performed significantly less cross-checks and found 25% fewer automation failures. Due to this social loafing effect, even the combined team performance did not surpass the performance of participants working alone. However, when participants expected individual performance feedback, their monitoring behavior and failure detection performance was similar to participants working alone and a team advantage became apparent.

CONCLUSION

Social loafing in redundant automation monitoring can negate the expected gain, if individual performance feedback is not provided.

APPLICATION

These findings may motivate safety experts to evaluate whether their implementation of human redundancy is vulnerable to social loafing effects.

The polarizing effects of group discussion in a negative normative context: Integrating societal-, group-, and individual-level factors

In this research, we investigate how a negative (or hostile) norm regarding minorities at the societal level can fuel polarization between majority subgroups at the local level. We hypothesize that rapid social change in the form of polarization results from the interplay between small group processes and perceptions of society at large. By employing a novel analytic approach that uses variances to capture non‐linear societal change, we were able to study polarization processes. In three studies among high school and university students (N = 347), we manipulated the majority norm about a minority category (positive vs. negative). Subsequently, participants read about a minority member's ambiguous behaviour and evaluated this target. All studies used a similar paradigm, but they varied in whether or not participants discussed the ambiguous behaviour within local groups. Results showed that the majority norm at the societal level affected perceptions of the minority member's behaviour when people discussed this behaviour in a local majority group but not when they reflected on it individually. Specifically, group discussions led to polarization between local groups within a broader social category, but only in the context of a negative majority norm. This effect was predicted by the a priori perception of the local group norm. Results are discussed in terms of the integration of society‐ and group‐level processes when studying the development of intergroup attitudes and practical implications for the coarsening climate of the societal debate about current societal issues.

Team-level identification predicts perceived and actual team performance: Longitudinal multilevel analyses with sports teams

Social identification and team performance literatures typically focus on the relationship between individual differences in identification and individual-level performance. By using a longitudinal multilevel approach, involving 369 members of 45 sports teams across England and Italy, we compared how team-level and individual-level variance in social identification together predicted team and individual performance outcomes. As hypothesized, team-level variance in identification significantly predicted subsequent levels of both perceived and actual team performance in cross-lagged analyses. Conversely, individual-level variance in identification did not significantly predict subsequent levels of perceived individual performance. These findings support recent calls for social identity to be considered a multilevel construct and highlight the influence of group-level social identification on group-level processes and outcomes, over and above its individual-level effects.

Singing for people with aphasia (SPA): a protocol for a pilot randomised controlled trial of a group singing intervention to improve well-being

INTRODUCTION

The singing for people with aphasia (SPA) intervention aims to improve quality of life and well-being for people with poststroke aphasia. A definitive randomised controlled trial (RCT) is required to assess the clinical and cost effectiveness of SPA. The purpose of this pilot study is to assess the feasibility of such a definitive trial and inform its design.

METHODS AND ANALYSIS

A two-group, assessor-blinded, randomised controlled external pilot trial with parallel mixed methods process evaluation and economic evaluation. Forty-eight participants discharged from clinical speech and language therapy will be individually randomised 1:1 to SPA (10 group sessions plus a resource booklet) or control (resource booklet only). Outcome assessment at baseline, 3 and 6 months postrandomisation include: ICEpop CAPability measure for adults, Stroke and Aphasia Quality of Life, EQ-5D-5L, modified Reintegration into Normal Living Index, Communication Outcome After Stroke, Very Short Version of the Minnesota Aphasia Test, Service Receipt Inventory and Care Related Quality of Life. Feasibility, acceptability and process outcomes include recruitment and retention rates, with measurement burden and trial experiences being explored in qualitative interviews (15 participants, 2 music facilitators and 2 music champions). Analyses include: descriptive statistics, with 95% CIs where appropriate; qualitative themes; intervention fidelity from videos and session checklists; rehearsal of health economic analysis.

ETHICS AND DISSEMINATION

NHS National Research Ethics Service and the Health Research Authority confirmed approval in April 2017; recruitment commenced in June 2017. Outputs will include: pilot data to inform whether to proceed to a definitive RCT and support a funding application; finalised intervention manual for multicentre replication of SPA; presentations at conferences, public involvement events; internationally recognised peer reviewed journal publications, open access sources and media releases.

TRIAL REGISTRATION NUMBER

NCT03076736.

Athletes' perceptions of coaching competency and team conflict in sport teams: A multilevel analysis

The purpose of this study was to examine the relationship between coaching competency and team conflict, at individual and team levels, over the season. The participants were professional female and male soccer players, who participated in the First and Second Division. A longitudinal study was performed. At Time 1, the sample of participants consisted of 581 soccer players aged between 15 and 39 years. At Time 2, 549 players were recruited from the original sample aged between 15 and 37 years. Finally, at Time 3, the sample comprised 576 players aged between 15 and 37 years. All participants completed a multi-section questionnaire assessing coaching competency (motivation, game strategy, technique competency, and character-building competency) and team conflict (task conflict and relationship conflict). Results showed that both task and relationship conflict increased significantly over time. Multilevel modelling analysis showed that game strategy and character-building competencies negatively predicted both task and relationship conflicts at the individual level, whereas motivation competency was also added as a significant predictor of task conflict at the team level. Moreover, technique competency positively predicted task conflict at the team level. The current study suggests the importance of coaching competency in group dynamics in sport.

Greater University Identification-But not Greater Contact-Leads to More Life Satisfaction: Evidence from a Spanish Longitudinal Study

BACKGROUND

A growing body of literature has highlighted the relationship between group identification (a subjective sense of belonging to one's social group, coupled with a subjective sense of commonality with the group's members) and well-being. However, little of this work is longitudinal, and few studies address reciprocal causality or control for intensity of contact with fellow group members.

METHOD

We investigated the effect of university identification on satisfaction with life (SWL) over time (and vice versa) in 216 Spanish undergraduates, with seven months between T1 and T2.

RESULTS

While greater university identification T1 predicted higher SWL T2, SWL T1 did not predict university identification T2. University contact T1 was unrelated to SWL T2.

CONCLUSIONS

These results show that university identification impacts positively on SWL over time (rather than SWL impacting positively on university identification over time), and this is not reducible to the effects exerted by university contact. The implications for those who work with students are discussed.

How do Small Groups Promote Behaviour Change? An Integrative Conceptual Review of Explanatory Mechanisms

BACKGROUND

Small groups are used to promote health, well-being, and personal change by altering members' perceptions, beliefs, expectations, and behaviour patterns. An extensive cross-disciplinary literature has articulated and tested theories explaining how such groups develop, function, and facilitate change. Yet these theoretical understandings are rarely applied in the development, description, and evaluation of health-promotion, group-based, behaviour-change interventions.

METHODS

Medline database, library catalogues, search engines, specific journals and reference lists were searched for relevant texts. Texts were reviewed for explanatory concepts or theories describing change processes in groups, which were integrated into the developing conceptual structure. This was designed to be a parsimonious conceptual framework that could be applied to design and delivery.

RESULTS

Five categories of interacting processes and concepts were identified and defined: (1) group development processes, (2) dynamic group processes, (3) social change processes, (4) personal change processes, and (5) group design and operating parameters. Each of these categories encompasses a variety of theorised mechanisms explaining individual change in small groups.

CONCLUSION

The final conceptual model, together with the design issues and practical recommendations derived from it, provides a practical basis for linking research and theory explaining group functioning to optimal design of group-based, behaviour-change interventions.

A "Collective Effort to Make Yourself Feel Better": The Group Process in Mindfulness-Based Interventions

There is growing interest in mindfulness-based interventions (MBIs) in the management of multiple physical and mental health issues. Although MBIs utilize a group format, research on how this format impacts teaching and learning mindfulness is lacking. This study aimed to develop a detailed theory of MBI group processes utilizing a grounded theory methodology. This article presents our subsequent model, developed from semistructured interviews conducted with MBI students, teachers, and trainers ( N = 12). A core category, the group as a vessel on a shared journey, and three higher-order categories emerged from the data. They illustrate how MBI group processes navigate a characteristic path. Teachers build and steer the group "vessel" in a way that fosters a specific culture and sense of safety. The group is facilitated to share communal experiences that augment learning and enrich mindfulness practice. Limitations and implications for clinicians and researchers are discussed.

The Psychology of Rituals: An Integrative Review and Process-Based Framework

Traditionally, ritual has been studied from broad sociocultural perspectives, with little consideration of the psychological processes at play. Recently, however, psychologists have begun turning their attention to the study of ritual, uncovering the causal mechanisms driving this universal aspect of human behavior. With growing interest in the psychology of ritual, this article provides an organizing framework to understand recent empirical work from social psychology, cognitive science, anthropology, behavioral economics, and neuroscience. Our framework focuses on three primary regulatory functions of rituals: regulation of (a) emotions, (b) performance goal states, and (c) social connection. We examine the possible mechanisms underlying each function by considering the bottom-up processes that emerge from the physical features of rituals and top-down processes that emerge from the psychological meaning of rituals. Our framework, by appreciating the value of psychological theory, generates novel predictions and enriches our understanding of ritual and human behavior more broadly.

Sleep Deprivation Impairs and Caffeine Enhances My Performance, but Not Always Our Performance

What effects do factors that impair or enhance performance in individuals have when these individuals act in groups? We provide a framework, called the GIE ("Effects of Grouping on Impairments and Enhancements") framework, for investigating this question. As prominent examples for individual-level impairments and enhancements, we discuss sleep deprivation and caffeine. Based on previous research, we derive hypotheses on how they influence performance in groups, specifically process gains and losses in motivation, individual capability, and coordination. We conclude that the effect an impairment or enhancement has on individual-level performance is not necessarily mirrored in group performance: grouping can help or hurt. We provide recommendations on how to estimate empirically the effects individual-level performance impairments and enhancements have in groups. By comparing sleep deprivation to stress and caffeine to pharmacological cognitive enhancement, we illustrate that we cannot readily generalize from group results on one impairment or enhancement to another, even if they have similar effects on individual-level performance.

Group therapy processes and treatment outcomes in 2 couple-focused group interventions for breast cancer patients

BACKGROUND

There has been little attention paid to the role of therapeutic processes in group therapy outcomes for cancer patients participating in group. The goal was to evaluate the contribution of 3 group processes-group climate (conflict, engagement, and avoidance) working alliance and therapeutic realizations-to the outcomes of 2 couple-focused approaches to group treatment.

METHODS

Three hundred and two women with early stage breast cancer and their partners were randomized to one of 2 conditions: an 8-session enhanced couple-focused group (ECG) intervention or a couples' support group participated. Couples completed measures of depressive symptoms and well-being before and 6 months after group. Group process measures were completed after sessions 4 and 8.

RESULTS

Support group participants (both patients and partners) perceived higher engagement and less avoidance than ECG participants. Conflict, working alliance, and therapeutic realizations did not differ. Group engagement, working alliance, and therapeutic realizations increased, and group conflict decreased over the course of both treatments. Greater conflict was associated with more posttreatment anxiety and lower well-being, and engagement was associated with higher posttreatment well-being. Patients whose partners reported higher conflict reported greater posttreatment anxiety. Working alliance was associated with posttreatment anxiety for ECG patients and with well-being among participants whose partners reported higher working alliance.

CONCLUSIONS

Fostering a positive group environment bolsters treatment efficacy for women with early stage breast cancer and their partners attending couple-focused groups. Facilitating the leader-member alliance bolsters treatment efficacy. Improving engagement with one member of a couple impacts the other member.

Using Groups to Measure Intergroup Prejudice

Implicit measures of racial attitudes often assess reactions to images of individuals to infer attitudes toward an entire social category. However, an increasing amount of research indicates that responses to individuals are highly dependent on context and idiosyncratic features of individual exemplars. Thus, using images of individuals to assess beliefs about a whole social category may not be ideal. Across three time points, we predicted that using images of groups would mitigate the influence of idiosyncratic features of individual targets and, thus, provide a better measurement tool to assess beliefs about a category to which all group members belong. Results revealed that an implicit measure that presented images of Black and White groups had greater construct validity, test-retest reliability, and predictive validity as compared with an implicit measure that presented the same exemplars individually. We conclude that groups provide a window into existing beliefs about social categories.