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Clinical change in anger, shame, and paranoia after a structured cognitive-behavioral group program: Early findings from a randomized trial with male prison inmates

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Abstract

Objectives

This study’s main goal was to assess the efficacy of a structured cognitive-behavioral group program, Growing Pro-Social (GPS), in reducing anger, paranoia, and external shame in male prison inmates.

Methods

In this randomized trial, a treatment group (n = 24) was compared to a control group (n = 24) and both groups were assessed at pre- and post-treatment. Participants answered the State-Trait Anger Expression Inventory, the Paranoia Scale, and the Other as Shamer scale. Treatment effects were tested using ANCOVA with baseline as covariate and condition as fixed factor. Additionally, in order to assess significant clinical change after intervention, the Reliable Change Index (RCI) was computed.

Results

At baseline, no significant differences between conditions were found. ANCOVA with baseline as covariate showed significant differences between groups at post-treatment. When compared to controls, treatment subjects showed lower scores in anger-trait (temperament and reaction subscales) and paranoia. Concerning clinical change, a high percentage of treatment subjects presented improvements in anger, paranoia, and external shame; the majority of controls showed significant deterioration in the same variables. After treatment, differences between groups were observed in the distributions by clinical change categories for anger-trait and its subscales, and paranoia. No differences between groups were found in anger-state and external shame.

Conclusions

These results point out the GPS’s ability to promote significant change in cognitive- and emotional-relevant variables associated with antisocial behavior.

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References

  • Allan, S., Gilbert, P., & Goss, K. (1994). An exploration of shame measures: psychopathology. Personality and Individual Differences, 17, 719–722. doi:10.1016/0191-8869(94)90150-3.

    Article  Google Scholar 

  • Andrews, D. A., & Bonta, J. (2010a). Rehabilitating criminal justice policy and practice. Psychology, Public Policy, and Law, 16, 39–55. doi:10.1037/a0018362.

    Article  Google Scholar 

  • Andrews, D. A., & Bonta, J. (2010b). The psychology of criminal conduct. Newark: LexisNexis/Matthew Bender.

    Google Scholar 

  • Andrews, D. A., & Dowden, C. (2005). Managing correctional treatment for reduced recidivism: a meta-analytic review of programme integrity. Legal and Criminological Psychology, 10, 173–187. doi:10.1348/135532505X36723.

    Article  Google Scholar 

  • Andrews, D. A., Zinger, I., Hoge, R. D., Bonta, J., Gendreau, P., & Cullen, F. T. (1990). Does correctional treatment work? A clinically relevant and informed meta-analysis. Criminology, 28, 369–404. doi:10.1111/j.1745-9125.1990.tb01330.x.

    Article  Google Scholar 

  • Andrews, D. A., Bonta, J., & Wormith, J. S. (2006). The recent past and near future of risk and/or need assessment. Crime and Delinquency, 52, 7–27. doi:10.1177/0011128705281756.

    Article  Google Scholar 

  • Ashkar, P. J., & Kenny, D. T. (2008). Young offenders’ subjective experiences of incarceration. International Journal of Offender Therapy and Comparative Criminology, 52(5), 584–597. doi:10.1177/0306624X08314181.

    Article  Google Scholar 

  • Atkins, C. D., Bedics, J. D., McGlinchey, J. B., & Bauchaine, T. (2005). Assessing clinical significance: does it matter which method we use? Journal of Consulting and Clinical Psychology, 73(5), 982–989. doi:10.1037/0022-006X.73.5.982.

    Article  Google Scholar 

  • Ball, S. A., & Cecero, J. J. (2001). Addicted patients with personality disorders: traits, schemas, and presenting problems. Journal of Personality Disorders, 15(1), 72–83. doi:10.1521/pedi.15.1.72.18642.

    Article  Google Scholar 

  • Bentall, R., & Kaney, S. (1996). Abnormalities of self-representation and persecutory delusions: a test of a cognitive model of paranoia. Psychological Medicine, 26, 1231–1237. doi:10.1017/S0033291700035959.

    Article  Google Scholar 

  • Bernstein, D. P. (2008). Agreement of raters in identifying schema modes from videotapes of therapy sessions. Paper presented at the 3rd Annual Meeting of International Society of Schema Therapy, Coimbra, Portugal.

  • Bogestad, A. J., Kettler, R. J., & Hagan, M. P. (2009). Evaluation of a cognitive intervention program for juvenile offenders. International Journal of Offender Therapy and Comparative Criminology, 54(4), 552–565. doi:10.1177/0306624X 09337211.

    Article  Google Scholar 

  • Brazão, N., da Motta, C., & Rijo, D. (2013). From multimodal programs to a new cognitive-interpersonal approach in the rehabilitation of offenders. Aggression and Violent Behavior, 18, 636–643. doi:10.1016/j.avb.2013.07.018.

    Article  Google Scholar 

  • Caldwell, M. F., & Rybroek, G. J. V. (2005). Reducing violence in serious juvenile offenders using intensive treatment. International Journal of Law and Psychiatric, 28, 622–636. doi:10.1016/j.ijlp.2004.07.001.

    Article  Google Scholar 

  • Calvete, E. (2008). Justification of violence and grandiosity schemas as predictors of antisocial behavior in adolescents. Journal of Abnormal Child Psychology, 36(7), 1083–1095. doi:10.1007/s10802-008-9229-5.

    Article  Google Scholar 

  • Chakhssi, F., Bernstein, D. P., & de Ruiter, C. (2012). Early maladaptive schemas in relation to facets of psychopathy and institutional violence in offenders with personality disorders. Legal and Criminological Psychology, 18(1), 1–17. doi:10.1111/lcrp.12002.

    Google Scholar 

  • Conboy, J. (2003). Algumas medidas típicas univariadas da magnitude do efeito [Some typical univariate measures of the effect size]. Análise Psicológica, 2(21), 145–158. Retrieved from http://www.scielo.oces.ctes.pt/pdf/aps/v21n2/v21n2a02.pdf.

    Google Scholar 

  • Dowden, C., & Andrews, D. A. (2000). Effective and correctional treatment and violent reoffending: a meta-analysis. Canadian Journal of Criminology, 42(4), 449–467. Retrieved from http://www.questia.com/library/1G1-65954586/effective-correctional-treatment-and-violent-reoffending.

    Google Scholar 

  • Dowden, C., & Andrews, D. A. (2004). The importance of staff practice in delivering effective correctional treatment: a meta-analytic review of core correctional practice. International Journal of Offender Therapy and Comparative Criminology, 48(2), 203–214. doi:10.1177/0306624X03257765.

    Article  Google Scholar 

  • Downey, G., Freitas, A., Michaelis, B., & Khouri, H. (1998a). The self-fulfilling prophecy in close relationships: Rejection sensitivity and rejection by romantic partners. Journal of Personality and Social Psychology, 75(2), 545–60. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/9731324.

    Article  Google Scholar 

  • Downey, G., Lebolt, A., Rincón, C., & Freitas, A. (1998b). Rejection sensitivity and children’s interpersonal difficulties. Child Development, 69(4), 1074–1091. doi:10.1111/j.1467-8624.1998.tb06161.x/abstract.

    Article  Google Scholar 

  • Farmer, E., & Andrews, B. (2009). Shameless yet angry: shame and its relationship to anger in male young offenders and undergraduate controls. The Journal of Forensic Psychiatry and Psychology, 20(1), 48–65. doi:10.1080/1478994080220 5315.

    Article  Google Scholar 

  • Fenigstein, A., & Vanable, P. (1992). Paranoia and self-consciousness. Journal of Personality and Social Psychology, 62, 129–138. doi:10.1037/0022-3514.62.1.129 [Portuguese version by Lopes and Pinto Gouveia, 2005].

    Article  Google Scholar 

  • Garrett, C. G. (1985). Effects of residential treatment on adjudicated delinquents: a meta-analysis. Journal of Research in Crime and Delinquency, 22, 287–308. doi:10.1177/0622427885022 004002.

    Article  Google Scholar 

  • Gilbert, P. (1997). The evolution of social attractiveness and its role in shame, humiliation, guilt and therapy. British Journal of Medical Psychology, 70, 113–147. doi:10.1111/j.2044-83 41.1997.tb01893.x.

    Article  Google Scholar 

  • Gilbert, P. (1998). What is shame? Some core issues and controversies. In P. Gilbert & B. Andrews (Eds.), Shame: Interpersonal behavior, psychopathology and culture (pp. 3–38). New York: Oxford University Press.

    Google Scholar 

  • Gilbert, P. (2002). Body shame: A biopsychosocial conceptualization and overview with treatment implications. In P. Gilbert & J. Miles (Eds.), Body shame: Conceptualization, research and treatment (pp. 3–54). New York: Brunner-Routledge.

    Google Scholar 

  • Gilbert, P., & Miles, J. N. (2000). Sensitivity to social put-down: it’s relationship to perceptions of social rank, shame, social anxiety, depression, anger and self-other blame. Personality and Individual Differences, 29(4), 757–774. doi:10.1016/S0191-8869(99)00230-5.

    Article  Google Scholar 

  • Gilbert, P., & Procter, S. (2006). Compassionate mind training for people with high shame and self-criticism: a pilot study of a group therapy approach. Clinical Psychology and Psychotherapy, 13, 353–379. doi:10.1002/cpp.507.

    Article  Google Scholar 

  • Gilbert, P., Boxall, M., Cheung, M., & Irons, C. (2005). The relationship of paranoid ideation and social anxiety in a mixed clinical population. Clinical Psychology and Psychotherapy, 12, 124–133. doi:10.1002/cpp.438.

    Article  Google Scholar 

  • Gilbert, P., McEwan, K., Irons, C., Broomhead, C., Bellew, R., Mills, A., & Gale, C. (2009). The dark side of competition: how competitive behaviour and striving to avoid inferiority are linked to depression, anxiety, stress and self-harm. Psychology and Psychotherapy: Theory, Research and Practice, 82(2), 123–136. doi:10.1348/147608308X379806.

    Article  Google Scholar 

  • Goss, K., Gilbert, P., & Allan, S. (1994). An exploration of shame measures: the “Other as shamer scale”. Personality and Individual Differences, 17, 713–717. doi:10.1016/0191-8869(94)90149-X [Portuguese version by Matos, Pinto-Gouveia, and Duarte, 2011].

    Article  Google Scholar 

  • Gumley, A., Gillan, K., Morrison, A., & Schwannauer, M. (2011). The development and validation of the beliefs about Paranoia Scale (short form). Behavioural and Cognitive Psychotherapy, 39, 35–53. doi:10.1017/S135246581000055X.

    Article  Google Scholar 

  • Hollin, C. R., Palmer, E. J., & Hatcher, R. M. (2013). Efficacy of correctional cognitive skills programmes. In A. Craig, L. Dixon, & T. A. Gannon (Eds.), What works in offender rehabilitation: An evidence-based approach to assessment and treatment (pp. 117–128). Chichester: Wiley-Blackwell.

    Google Scholar 

  • Hosser, D., Windzio, M., & Greve, W. (2008). Guilt and shame as predictors of recidivism: a longitudinal study with young prisoners. Criminal Justice and Behavior, 35, 138–152. doi:10.1177/0093854807309224.

    Article  Google Scholar 

  • Jacobson, N. S., & Truax, P. (1991). Clinical significance: a statistical approach to defining meaningful change in psychotherapy research. Journal of Consulting and Clinical Psychology, 39(1), 12–19. Retrieved from http://www.personal.kent.edu/~dfresco/CRM_Readings/ JCCP_Jacobson_ClinSIG.pdf.

    Article  Google Scholar 

  • Lambie, I., & Randell, I. (2013). The impact of incarceration on juvenile offenders. Clinical Psychology Review, 33, 448–459. doi:10.1016/j.cpr.2013.01.007.

    Article  Google Scholar 

  • Lane, J., Lanza-Kaduce, L., Frazier, C. E., & Bishop, D. M. (2002). Adult versus juvenile sanctions: voices of incarcerated youths. Crime and Delinquency, 48(3), 431–455. doi:10.1177/0011128702048003004.

    Article  Google Scholar 

  • Lipsey, M. W. (1995). What do we learn from 400 research studies on the effectiveness of treatment with juvenile delinquents? In J. McGuire (Ed.), What works: Reducing reoffending? Guidelines from research and practice (pp. 63–78). London: Wiley Blackwell.

    Google Scholar 

  • Lipsey, M. W. (2009). The primary factors that characterize effective interventions with juvenile offenders: a meta-analytic overview. Victims and Offenders, 4, 124–147. doi:10.1080/1 5564880802612573.

    Article  Google Scholar 

  • Lipsey, M. W., & Wilson, D. B. (1998). Effective intervention for serious juvenile offenders: A synthesis of research. In R. Loeber & D. P. Farrington (Eds.), Serious and violent juvenile offenders: Risk factors and successful interventions (pp. 313-345). Thousand Oaks: Sape.

    Google Scholar 

  • Lipsey, M. W., Howell, J. C., Kelly, M. R., Chapman, G., & Carver, D. (2010). Improving the effectiveness of juvenile justice programs: A new perspective on evidence-based practice. Washington: Center for Juvenile Justice Reform.

    Google Scholar 

  • Lobbestael, J., Arntz, A., Cima, M., & Chakhssi, F. (2009). Effects of induced anger in patients with antisocial personality disorder. Psychological Medicine, 39, 5557–5568. doi:10.1017/S003 3291708005102.

    Article  Google Scholar 

  • Lösel, F. (1995). The efficacy of correctional treatment: A review and synthesis of meta-evaluations. In J. McGuire (Ed.), What works: Reducing reoffending? Guidelines from research and practice (pp. 79–111). London: Wiley Blackwell.

    Google Scholar 

  • Maaseen, G. (2001). The unreliable change of reliable change indices. Behaviour Research and Therapy, 39(4), 495–498. Retrieved from http://ac.els-cdn.com/S0005796700000292/1-s2.0S0005796700000292main.pdf?_tid=1eda58b5bd04bfa063042a7c29c64560 andacdnat=1339595064_5c6f36fed221e874b20 9241132a438ce.

    Article  Google Scholar 

  • Matos, M., & Pinto-Gouveia, J. (2010). Shame as a traumatic memory. Clinical Psychology and Psychotherapy, 312, 299–312. doi:10.1002/cpp.

    Google Scholar 

  • Matos, M., Pinto-Gouveia, J., & Gilbert, P. (2012). The effect of shame and shame memories on paranoid ideation and social anxiety in a general community sample. Clinical Psychology and Psychotherapy, 20(4), 334–349. doi:10.1002/cpp.1766.

    Article  Google Scholar 

  • McGuire, J. (2001). What works in correctional intervention? Evidence and practical implications. In G. A. Bernfeld, D. P. Farrington, & A. W. Leschied (Eds.), Implementing and evaluating effectives programs (pp. 25–43). Chichester: John Wiley and Sons.

    Google Scholar 

  • McGuire, J. (2011). Reducing recidivism of adult offenders: a review of methods and outcomes. Ousar Integrar – Revista de Reinserção Social e Prova, 8, 9–25.

    Google Scholar 

  • McGuire, J. (2013). ‘What works’ to reduce re-offending: 18 years on. In L. A. Craig, L. Dixon, & T. A. Gannon (Eds.), What works in offender rehabilitation: An evidence-based approach to assessment and treatment (pp. 20–49). Chichester: Wiley-Blackwell. doi:10.1002/9781 118320655.

    Chapter  Google Scholar 

  • Myers, D. L. (2003). The recidivism of violent youths in juvenile and adult court: a consideration of selection bias. Youth Violence and Juvenile Justice, 1(1), 79–101. doi:10.1177/1541204002238365.

    Article  Google Scholar 

  • Nestor, P. G. (2002). Mental disorder and violence: personality dimensions and clinical features. American Journal of Psychiatry, 159(12), 1973–1978. doi:10.1176/appi.ajp.159.12. 1973.

    Article  Google Scholar 

  • Novaco, R. W. (2010). Anger and psychopathology. In M. Potegal (Ed.), International handbook of anger (pp. 465–497). New York: Springer.

    Chapter  Google Scholar 

  • Pearson, F. S., Lipton, D. S., Cleland, C. M., & Yee, D. S. (2002). The effects of behavioral/cognitive-behavioral programs on recidivism. Crime and Delinquency, 48(3), 476–496. doi:10.1177/001112870204800306.

    Article  Google Scholar 

  • Rafaeli, E., Bernstein, D. P., & Young, J. (2011). Schema therapy: Distinctive features. New York: Routledge.

    Google Scholar 

  • Redondo, S., Garrido, V., & Sanchéz-Meca, J. (1997). What works in correctional rehabilitation in Europe: A meta-analytic review. In S. Redondo, V. Garrido, J. Pérez, & R. Barberet (Eds.), Advances in psychology and law: International contributions (pp. 449-523). Berlin: de Gruyter.

    Chapter  Google Scholar 

  • Redondo, S., Sanchéz-Meca, J., & Garrido, V. (1999). The influence of treatment programmes on the recidivism of juveniles and adult offenders: an European meta-analytic review. Psychology Crime and Law, 5, 251–278. doi:10.1080/10683169908401769.

    Article  Google Scholar 

  • Rijo, D., Sousa, M. N., Lopes, J., Pereira, J., Vasconcelos, J., Mendonça, M. C., … Massa, S. (2007). Gerar Percursos Sociais: Programa de prevenção e reabilitação para jovens com comportamento social desviante [Growing Pro-Social: Prevention and rehabilitation program for youths with deviant social behavior]. Ponta Delgada: EQUAL.

  • Safran, J. D., & McMain, S. (1992). A cognitive-interpersonal approach to the treatment of personality disorders. Journal of Cognitive Psychotherapy, 6, 59–68.

    Google Scholar 

  • Safran, J. D., & Segal, Z. V. (1990). Interpersonal process in cognitive therapy. New York: Basic Books, Inc.

    Google Scholar 

  • Silva, D. R., Campos, R., & Prazeres, N. (1999). O inventário do estado-traço de raiva (STAXI) e a sua adaptação para a população portuguesa [State-Trait Anger Expression Inventory adapted for the Portuguese population]. Revista Portuguesa de Psicologia, 34, 55–81.

    Google Scholar 

  • Skeem, J. L., Polaschek, D. L., & Manchak, S. (2009). Appropriate treatment works but how? Rehabilitating general psychopathic, and high-risk offenders. In J. L. Skeem, K. S. Douglas, & S. O. Lillenfeld (Eds.), Psychological science in the courtroom: Consensus and controversy (pp. 358–384). New York: Guilford.

    Google Scholar 

  • Spielberger, C. D. (1988). The experience, expression and control of anger. In C. D. Spielberger, S. S. Krasner, & E. P. Solomon (Eds.), Health psychology: Individual differences and stress (pp. 55–81). New York: Springer Verlag/Publishers.

    Google Scholar 

  • Spielberger, C. D. (1991). Manual of State-Trait Anger Expression Inventory. Florida: Psychological Assessment Resources, Inc.

    Google Scholar 

  • Tangney, J. P., & Dearing, R. L. (2002). Shame and guilt. New York: The Guilford Press.

    Book  Google Scholar 

  • Thimm, J. C. (2010). Mediation of early maladaptive schemas between perceptions of parental rearing style and personality disorder symptoms. Journal of Behavior Therapy and Experimental Psychiatry, 41(1), 52–59. doi:10.1016/j.jbtep.2009.10.001.

    Article  Google Scholar 

  • Thomaes, S., Bushman, B., Stegge, H., Olthof, T., & Nezlek, J. (2011). Turning shame inside-out: “humiliated Fury” in young adolescents. Emotion, 11(4), 786–793. doi:10.1037/a0023403.

    Article  Google Scholar 

  • Tracy, J. L., & Robins, R. W. (2004). Putting the self into self-conscious emotions: a theoretical model. Psychological Inquiry, 15, 103–125. doi:10.1207/s15327965p li1502_01.

    Article  Google Scholar 

  • Tremblay, P. F., & Dozois, D. J. A. (2009). Another perspective on trait aggressiveness: overlap with early maladaptive schemas. Personality and Individual Differences, 46(5–6), 569–574. doi:10.1016/j.paid.2008.12.009.

    Article  Google Scholar 

  • Wilson, D. B., Bouffard, L. A., & MacKenzie, D. L. (2005). A quantitative review of structured, group-oriented, cognitive-behavioral programs for offenders. Journal of Criminal Justice and Behavior, 32(2), 172–204. doi:10.1177/00938548 04272889.

    Article  Google Scholar 

  • Wise, E. A. (2004). Methods for analyzing psychotherapy outcomes: a review of clinical significance, reliable change, and recommendations for future directions. Journal of Personality Assessment, 82(1), 50–59. Retrieved from http://web.ebscohost.com/ehost/pdfviewer/pdfviewer?vid=3andhid=125andsid=ce888259-d218-4c67-9d09-ae0f4e7f4bf3%4 0sessionmgr11.

    Article  Google Scholar 

  • Young, J. E. (1990). Cognitive therapy for personality disorders: A schema-focused approach. Florida: Professional Resource Exchange, Inc.

    Google Scholar 

  • Young, J. E., & Klosko, J. S. (1994). Reinventing your life. New York: Plume.

    Google Scholar 

  • Young, J. E., & Lindemann, M. D. (1992). An integrative schema-focused model for personality disorders. Journal of Cognitive Psychotherapy, 6, 11–23.

    Google Scholar 

  • Young, J. E., Beck, A. T., & Weinberger, A. (1993). Depression. In D. H. Barlow (Ed.), Clinical handbook of psychological disorders (pp. 240–277). New York: The Guilford Press.

    Google Scholar 

  • Young, J. E., Klosko, J. S., & Weishaar, M. E. (2003). Schema therapy. A practioner’s guide. New York: The Guilford Press.

    Google Scholar 

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Acknowledgments

“GPS—Growing Pro-Social, a prevention and rehabilitation program for individuals with antisocial behavior: Efficacy studies in forensic samples” (PTDC/PSI-PCL/102165/2008) is supported by the Foundation for Science and Technology, and it is a partnership between the Research Unit of the Cognitive-Behavioral Research and Intervention Center and the General Directorship of Social Reinsertion and Prison Services of the Portuguese Ministry of Justice.

The authors would like to thank all prison staff members that collaborated in data collection, and Lara Palmeira and Sofia Gameiro for proofreading the manuscript.

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Authors and Affiliations

  1. Research Unit of the Cognitive-Behavioral Research and Intervention Center Faculty of Psychology and Education Sciences, University of Coimbra, Coimbra, Portugal

    Nélio Brazão, Carolina da Motta, Daniel Rijo, Maria do Céu Salvador, José Pinto-Gouveia & João Ramos

  2. Centro de Investigação do Núcleo de Estudos e Intervenção Cognitivo-Comportamental (CINEICC) da Faculdade de Psicologia e de Ciências da Educação da Universidade de Coimbra, Rua do Colégio Novo, 3001-802, Coimbra, Portugal

    Nélio Brazão

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  1. Nélio Brazão
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Brazão, N., da Motta, C., Rijo, D. et al. Clinical change in anger, shame, and paranoia after a structured cognitive-behavioral group program: Early findings from a randomized trial with male prison inmates. J Exp Criminol 11, 217–236 (2015). https://doi.org/10.1007/s11292-014-9224-5

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