To save content items to your account,
please confirm that you agree to abide by our usage policies.
If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account.
Find out more about saving content to .
To save content items to your Kindle, first ensure no-reply@cambridge.org
is added to your Approved Personal Document E-mail List under your Personal Document Settings
on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part
of your Kindle email address below.
Find out more about saving to your Kindle.
Note you can select to save to either the @free.kindle.com or @kindle.com variations.
‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi.
‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.
Individuals with severe mental illnesses (SMIs) experience anxiety that impairs functioning and quality of life. This cluster randomized trial evaluated exposure-based cognitive behavioral therapy (ebCBT) integrated into assertive community treatment (ACT) teams to reduce anxiety.
Methods
Fifteen ACT teams were allocated to ebCBT + ACT (k = 8, n = 50) or ACT-only (k = 7, n = 43). The intervention followed four steps: situation identification, four-component analysis (behavior, cognition, emotion, physical symptoms), psychoeducation, and graded exposure. Staff received 50 h training and bimonthly supervision over 12 months. Co-primary outcomes were trait and social anxiety; secondary outcomes were psychiatric symptoms, functioning, quality of life, and recovery.
Results
The ebCBT + ACT group showed significant improvements in State–Trait Anxiety Inventory–Trait scores at 12 months (AMD = −5.30, 95% CI = −8.71 to −1.90, p = 0.002, d = −0.64) and 18 months (AMD = −7.22, 95% CI = −12.1 to −2.34, p = 0.004, d = −0.60). Brief Fear of Negative Evaluation scores showed near-significant improvement at 18 months (AMD = −3.70, 95% CI = −7.44 to 0.04, p = 0.052, d = −0.40). Secondary outcomes, including global functioning, recovery, and quality of life, also improved. Cost-effectiveness analyses indicated favorable cost-effectiveness for anxiety outcomes.
Conclusions
Embedding ebCBT within ACT services may reduce anxiety-related fear and avoidance and enhance recovery-related outcomes in individuals with SMI. These findings support the feasibility and clinical value of integrating structured psychological interventions into intensive community-based outreach services.
This paper examines the applicability to the history of linguistics of Thomas Kuhn's conception of the history of science. It concludes that his notion of REVOLUTION, borrowed from the history of the non-sciences, can be applied to the history of linguistics; but the same is not true of his other key notion, the PARADIGM. The possession of paradigms, according to Kuhn, is what distinguishes the hard sciences from fields in the humanities and social sciences which have not achieved scientific maturity. Kuhn regards a paradigm as (1) resulting from an outstanding scientific achievement on the part of a single innovator, and (2) commanding uniform assent among all the members of the discipline. If these two requirements are to be everywhere met, the concept cannot be applied either to the history or the present state of linguistics. Serious objections can also be raised to other features of Kuhn's theory, such as the view that shifting allegiance from one paradigm to another is a largely irrational process. The paper recommends, then, that linguists abandon the theory.
This article offers a holistic approach to the understanding of Arizona Tewa passives by examining them from typological, genetic-historical, and areal-historical perspectives. Two types of functional passives, IMPERSONAL and SEMANTIC, are contrastively analysed in terms of their grammatical properties and discourse functions. Genetic-historical comparison reveals the Arizona Tewa semantic passive to be rather anomalous in terms of other Kiowa-Tanoan languages. Areal-historical comparison suggests the influence of Apachean languages. A strategy of combining these distinct perspectives for historical analysis is shown to provide a more precise tool for the anthropological linguistic study of the past.
This paper presents a theory of surface case which bears a strong formal similarity to autosegmental theory in phonology and morphology. We suggest that surface case forms a tier which is autonomous of phrase structure—and which is associated with NP's of the PS tier by general principles analogous to those which associate tones with segments, or phonemic melodies with CV skeleta. We show that this theory permits parameterization of a variety of case systems, and thus provides some insight into how case might be characterized in Universal Grammar. The theory permits, most strikingly, a unification of Accusative and Ergative systems under one simple parameter, and explanation of the mysterious appearance of postverbal nominative case in the passives of certain Icelandic ditransitive verbs.
The Anatolian branch of Indo-European is characterized by a split-ergative case-marking system in which neuters inflect ergatively and common-gender nouns inflect accusatively; its ergative case originated via the reanalysis of an unproductive neuter instrumental marker in null-subject transitive clauses. A development from instrumental to ergative also occurred in the prehistory of the Gorokan languages of Papua New Guinea, and it is suggested that this process is a general mechanism for the development of split ergativity of this type. The well-known NP hierarchy discovered by Silverstein receives a natural interpretation as a hierarchy of instrumentality.