Social anxiety and peer helping in adolescent addiction treatment

Probably not a substantial claim: may not pass S3 (load-bearing).

Not feeling socially accepted by peers strongly influences decisions to drink during adolescence.

“While not feeling socially accepted by peers may matter less with age, it strongly influences decisions to drink during adolescence (Crosnoe et al., 2012)”

• cites Crosnoe et al., 2012 sourceDisputed

  In Results, “Drinking and Socioemotional Functioning,” earlier feelings of loneliness and not fitting in were not associated with later drinking after adjustment. That finding contradicts the claim that not feeling socially accepted strongly influences adolescents’ decisions to drink. Page numbers were not provided in our copy. (LLM, conf=0.89)

  Checked by a reasoning model — may be wrong.

  Experimental — accuracy not yet measured

May combine two claims.

Adults with SAD report lower post-meeting well-being than adults without SAD and are less likely to lead a meeting.

“For example, adults with SAD report not feeling as good after a meeting as those without SAD and are less likely to chair a meeting, and women with SAD are less likely to ask someone to sponsor them (Terra et al., 2006; Tonigan et al., 2010).”

• cites Terra et al., 2006 sourceNot checked — no full text of the source
• cites Tonigan et al., 2010 sourceSupported

May combine two claims.

Enrolled and non-enrolled but treated adolescents did not differ significantly in intake characteristics or treatment completion rates.

“There were no significant differences between youths enrolled versus not enrolled but treated during the enrollment period in terms of intake characteristics and rates of treatment completion, as reported in detail elsewhere (Kelly et al., 2011).”

• cites Kelly et al., 2011 sourcePartly supported

  The Subjects section reports no significant differences between enrolled and non-enrolled adolescents on several intake characteristics or the likelihood of residential treatment completion. It also reports a significant difference in gender composition (50% girls versus 17%), so the unqualified statement about intake characteristics is too broad. (LLM, conf=0.90)

  Experimental — accuracy not yet measured

May combine two claims.

Adults seeking treatment who have social anxiety speak less in group therapy, talk less with their therapist, and avoid treatment tasks that require public speaking.

“Treatment-seeking adults with social anxiety are less likely to speak up in group therapy, talk to their therapist, or participate in treatment activities involving public speaking (Book et al., 2009).”

• cites Book et al., 2009 sourcePartly supported

  The Results and Discussion report that treatment-seeking clients with social anxiety were more likely to say shyness interfered with their willingness to talk to a therapist, speak in group therapy, and attend AA/NA meetings, which the Introduction describes as involving public speaking. The Discussion explicitly says the study measured attitudes, not actual behavior, so it does not establish that these adults spoke less or avoided those activities. (LLM, conf=0.89)

  Experimental — accuracy not yet measured

May combine two claims.

The low-intensity service activities in AA offer youths, and those with SAD in particular, a nonjudgmental, task-focused venue for social connectedness, reduce self-preoccupation and feeling like a misfit, and transform a troubled past to usefulness with others.

“The low-intensity service activities in AA offer youths—and those with SAD in particular—a nonjudgmental, task-focused venue for social connectedness, reduce self-preoccupation and feeling like a misfit, and transform a troubled past to usefulness with others (Pagano et al., 2011).”

• cites Pagano et al., 2011 sourcePartly supported

  Split into 2 atoms — 0 confirmed, 2 partially supported, 0 disputed, 0 misattributed, 0 unverifiable. Expand the claim to see per-atom verdicts.

  Experimental — accuracy not yet measured

Probably not a substantial claim: may not pass S3 (load-bearing).

Intracorrelations between outcomes (AOD use and psychosocial functioning) collected at intake, discharge, and 6 months posttreatment were low (rs = -0.1 to 0.2, ns).

“Intracorrelations between outcomes (AOD use, psychosocial functioning) collected at intake, discharge, and 6 months posttreatment were low (rs = −0.1 to 0.2, ns).”

May combine two claims.

SAD was associated with greater incarceration history, lifetime use of heroin, polysubstance use, and earlier age of first use.

“SAD was associated with greater incarceration history, lifetime use of heroin, polysub-stance use, and earlier age of first use (Table 1).”

May combine two claims.

The top peer-helping activities rated often or always by SAD youths were putting away chairs after a meeting (80%) and guiding another with step-work (75%), whereas youths without SAD most often rated sharing one's personal story with another alcoholic (70%) and reading introductory/closing literature at a meeting (65%).

“The top 2 peer-helping activities that were rated “often” or “always” by SAD youths were putting away chairs after a meeting (80%) and guiding another with step-work (75%). In comparison, peer-helping activities rated “often” or “always” the most by youths without SAD were sharing one’s personal story with another alcoholic (70%) and reading introductory/closing literature at a meeting (65%).”

Probably not a substantial claim: may not pass S3 (load-bearing).

Other Axis I disorders started, on average, 2.4 years after SAD began.

“Concurrent Axis I disorders onset an average of 2 years (M = 2.4, SD = 1.6) after SAD onset, as described elsewhere (Carruthers et al., 2012; Wang et al., 2013).”

• cites Carruthers et al., 2012Not matched

  Couldn’t be matched to a paper in Crossref, so it can’t be checked.

• cites Wang et al., 2013Not matched

  Couldn’t be matched to a paper in Crossref, so it can’t be checked.

May combine two claims.

Twelve-step participation significantly improved in terms of increased meeting attendance (t = -15.7, p < 0.001), increased peer-helping (t = -7.8, p < 0.001), and a higher proportion having a sponsor at discharge (23%; Q = 8.1, p < 0.001).

“Twelve-step participation significantly improved in terms of increased meeting attendance (t = −15.7, p < 0.001), peer-helping (t = −7.8, p < 0.001), and the proportion having a sponsor at discharge (23%; Q = 8.1, p < 0.001).”

May combine two claims.

At discharge, there were no differences between youths with and without SAD in treatment completion, treatment duration, percentage of days abstinent, global functioning, meeting attendance, or having a sponsor.

“At discharge, there were no differences between youths with or without SAD in terms of treatment completion or duration, PDA, global functioning, meeting attendance, and having a sponsor (Table 3).”

May combine two claims.

SAD was significantly associated with higher levels of peer-helping and with scoring above the threshold for high helping (43% SAD vs. 30% no SAD; chi-square = 4.5, p < 0.05).

“SAD was significantly associated with higher levels of peer-helping and scoring above threshold for high helping (43% SAD vs. 30% no SAD; χ2 = 4.5, p < 0.05).”

May combine two claims.

Intracorrelations between 12-step indices were low to moderate at intake (rs = 0.2 to 0.4, p < 0.01) and at discharge (rs = 0.2 to 0.3, p < 0.01).

“Intracorrelations between 12-step indices were low to moderate at intake (rs = 0.2 to 0.4, p < 0.01) and discharge (rs = 0.2 to 0.3, p < 0.01).”

May combine two claims.

Peer-helping was associated with reduced risk of incarceration, which involved AOD use in most incidences.

“Peer-helping was also associated with reduced risk of incarceration, which involved AOD use in most incidences.”

May combine two claims.

In this study, SAD youths with low helping behavior had the lowest rate of sustained sobriety in the 6 months posttreatment, whereas SAD youths with high helping maintained sobriety at rates comparable to high helpers without SAD.

“In this study, SAD youths with low helping behavior had the lowest rate of sustained sobriety in the 6 months posttreatment, whereas SAD youths with high helping maintained sobriety at rates comparable to high helpers without SAD.”

May combine two claims.

Most relapses involved marijuana and alcohol (85%), with a portion using marijuana with inhalants (11%) or narcotics only (4%).

“most relapses involved marijuana and alcohol (85%), with a portion using marijuana with inhalants (11%) or narcotics only (4%).”

May combine two claims.

The likelihood of relapse was significantly lower for SAD youths and for high helpers, with evidence of a mediational effect of peer-helping.

“The likelihood of relapse was significantly lower for SAD youths and high helpers, with evidence of a mediational effect of peer-helping.”

May combine two claims.

SAD onset occurred before initial AOD use for most SAD youths (67%), at an average age of 11.2 years (SD = 3.1).

“SAD onset before initial AOD use for most SAD youths (67%) at the average age of 11.2 years (SD = 3.1).”

May combine two claims.

Although SAD was associated with more jail episodes prior to treatment, there was no main effect of SAD on incarceration posttreatment.

“Although SAD was associated with more jail episodes prior to treatment, there was no main effect of SAD on incarceration posttreatment.”

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

Among participants eligible for the six-month interview, 87% completed it; completers and non-completers did not differ significantly in intake characteristics, treatment completion, or treatment duration.

“Of those eligible for scheduling of their 6-month interview (N = 179), 87% (N = 156) completed a 6-month interview. There were no significant differences between participants with and without a 6-month interview in terms of intake characteristics, treatment completion, or treatment duration (Table 2).”

May combine two claims.

Socially anxious youths use alcohol and other drugs to reduce discomfort, and this self-medicating response can develop into addiction and a recurring drink/trouble cycle.

“Socially anxious youths soon discover that AOD use can diminish their discomfort (Robinson et al., 2011; Terra et al., 2006); this self-medicating response can develop into addiction and set in motion a drink/trouble, drink/trouble cycle that may require treatment to interrupt.”

• cites Robinson et al., 2011Not matched

  Couldn’t be matched to a paper in Crossref, so it can’t be checked.

• cites Terra et al., 2006 sourceNot checked — no full text of the source

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

The 4-item Traumatic Experiences scale, adapted from the Massachusetts Youth Screening Inventory, measured lifetime trauma and had good internal consistency in this sample (α = 0.86).

“Lifetime trauma was assessed with the 4-item Traumatic Experiences scale adapted from the valid Massachusetts Youth Screening Inventory (Grisso and Barnum, 2000), which showed good internal consistency in the current sample (α = 0.86).”

• cites Grisso and Barnum, 2000Not matched

  Couldn’t be matched to a paper in Crossref, so it can’t be checked.

Probably not a substantial claim: may not pass S3 (load-bearing).

Relapse occurs in 60% to 90% of patients during the first six months after treatment.

“The daunting reality is that 60 to 90% of patients relapse in the initial 6 months posttreatment (Miller et al., 2001), and the lifelong illness of addiction requires ongoing recovery supports.”

• cites Miller et al., 2001 sourceNot checked — no full text of the source

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

A discharge interview was completed by 96% of participants, and those who completed it did not differ significantly at intake from those who did not.

“Ninety-six percent of the sample completed a discharge interview, with no significant differences at intake between participants with (N = 185, 96%) and without a discharge interview (N = 8, 4%).”

Probably not a substantial claim: may not pass S3 (load-bearing).

Interviewers received training through tutorials, practice interviews, role-playing, and supervised sessions with PI feedback.

“Training of interviewers included didactic tutorials, mock interviews and role-playing, and supervised interviews with detailed feedback provided by the Principal Investigator.”

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

The Case Medical Center IRB approved all study procedures, and the study obtained a Certificate of Confidentiality from NIAAA.

“All study procedures were approved by the Case Medical Center Institutional Review Board for human investigation, and a Certificate of Confidentiality from the National Institute on Alcohol Abuse and Alcoholism was obtained.”

May combine two claims.

Social anxiety disorder is roughly five times more likely to come before substance-use disorders than after them, and it is the anxiety disorder most often comorbid with substance-use disorders.

“SAD is 5 times more likely to precede AOD-use disorders and the most common co-occurring anxiety disorder with AOD-use disorders (Buckner et al., 2008; Zimmer-man et al., 2003).”

• cites Buckner et al., 2008 sourceNot checked — no full text of the source
• cites Zimmer-man et al., 2003Not matched

  Couldn’t be matched to a paper in Crossref, so it can’t be checked.

May combine two claims.

SAD interferes with willingness to give speeches but not with willingness to meet strangers in the social context of AA.

“and that SAD interferes with willingness to give speeches but not to meet strangers in the social context of AA.”

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

Tested models were not exhaustive, and other nonspecified variables could also account for observed relationships.

“tested models were not exhaustive, and other nonspecified variables could also account for observed relationships.”

May combine two claims.

The hypothesis that higher peer-helping would be associated with SAD was confirmed, with one-to-one service activities engaged in the most.

“Our hypothesis of higher peer-helping associated with SAD was confirmed, with one-to-one service activities engaged in the most.”

Probably not a substantial claim: may not pass S3 (load-bearing).

Paroxetine is an effective medication for SAD.

“effective medications for SAD such as paroxetine (Book et al., 2008) are considered”

• cites Book et al., 2008Not matched

  Couldn’t be matched to a paper in Crossref, so it can’t be checked.

Probably not a substantial claim: may not pass S3 (load-bearing).

The YRBS items had high internal consistency (α = 0.92-0.93).

“YRBS items showed high internal consistency (α = 0.92 to 0.93).”

May combine two claims.

Results indicated that peer-helping increased the chances of SAD youths staying sober posttreatment, confirming the hypothesis for 1 of 2 outcomes.

“Results indicated that peer-helping increased the chances of SAD youths staying sober posttreatment, confirming our hypothesis for 1 of 2 outcomes.”

Probably not a substantial claim: may not pass S3 (load-bearing).

Tests for violations of the proportional hazard assumption found no evidence of nonproportionality in the Cox regression model.

“Tests for violations of the proportional hazard assumption found no evidence of nonproportionality in the Cox regression model.”

Probably not a substantial claim: may not pass S3 (load-bearing).

Empirically based behavioral modalities for SAD exist.

“empirically based behavioral modalities for SAD are implemented into individualized treatment plans (Randall et al., 2001).”

• cites Randall et al., 2001 sourceNot checked — no full text of the source

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

Examination of the correlation matrix for independent variables found no correlation to exceed 0.3, and collinearity diagnostics indicated no problems.

“Examination of the correlation matrix for independent variables in analytic models found no correlation to exceed 0.3 and collinearity diagnostics indicated no problems.”

May combine two claims.

Data were collected prospectively using valid and reliable instruments that employed multiple informants and methods.

“Data were collected prospectively using valid and reliable instruments that employed multiple informants (i.e., rater-administered, clinician assessments, and youth reports) and methods (i.e., biomarkers, semi-structured interviews, self-reports, medical chart review, and public records).”

Probably not a substantial claim: may not pass S3 (load-bearing), S4 (based). May combine two claims.

Higher peer-helping among SAD youths is likely to have promoted their meeting attendance and facilitated conversations with other AA members to ask for sponsorship.

“Higher peer-helping among SAD youths is likely to have promoted their meeting attendance and facilitated conversations with other AA members to ask for their sponsorship.”

Probably not a substantial claim: may not pass S3 (load-bearing).

The functional impairment threshold may underrepresent the rate of SAD if activities in school, work, and relationships selected have minimal distressing situations that trigger SAD symptoms.

“the functional impairment threshold may underrepresent the rate of SAD if activities in school, work, and relationships selected have minimal distressing situations that trigger SAD symptoms.”

May combine two claims.

This study had high retention of a large, representative sample of juvenile offenders (52% female, 30% minority) notoriously difficult to follow.

“Last, this study had high retention of a large, representative sample of juvenile offenders (52% female, 30% minority) notoriously difficult to follow.”

May combine two claims.

Contrary to the hypothesis, meeting attendance and rates of having a sponsor were similar between youths with and without SAD.

“Contrary to our hypothesis, meeting attendance and rates of having a sponsor were similar between youths with and without SAD.”

Probably not a substantial claim: may not pass S3 (load-bearing).

Preliminary analyses suggested that linear modeling was adequate.

“Preliminary analyses suggested that linear modeling was adequate.”

Probably not a substantial claim: may not pass S3 (load-bearing).

Other strengths include sufficient power (>80%) to detect at least moderate effects.

“Other strengths include sufficient power (i.e., >80%) to detect at least moderate effects”

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

Gender segregation of living quarters and gender-specific group sessions during treatment may have minimized SAD girls' fear of scrutiny and being accepted by the opposite sex, allowing more practice in speaking up and sharing vulnerabilities in coed settings.

“However, the gender segregation of living quarters and gender-specific group sessions during treatment may have minimized SAD girls’ fear of scrutiny and being accepted by the opposite sex to allow for more practice in speaking up and sharing vulnerabilities in coed settings.”