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Running head: Prisoners & Social Exclusion
Can the chronic exclusion-resignation link be broken?
An analysis of support groups within prisons
Nicolas Aureli, Marco Marinucci, and Paolo Riva
University of Milano-Bicocca
Correspondence concerning this article should be addressed to Marco Marinucci,
Department of Psychology, University of Milano-Bicocca, Milano, Italy.
e-mail: m.marinucci@campus.unimib.it
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Abstract
Social exclusion, especially when prolonged over time – has a strong impact on the
individuals’ health and wellbeing. According to Williams’ (2009) Temporal Need-Threat Model,
the experience of chronic social exclusion inescapably leads to a condition of resignation,
characterized by feelings of alienation, depression, helplessness, and unworthiness. However, few
empirical studies have tested this prediction and its potential moderating factors. In this research,
we identified the prison as a prototypical condition of chronic social exclusion, and aimed at a)
empirically testing the link between chronic exclusion and the resignation stage, b) investigating
whether situational factors – such as attending a support group in prison – can reduce the adverse
outcomes of the resignation, and c) exploring the role of individual differences (e.g., psychological
flexibility) in mediating the effect of the support group on the resignation. The study involved 136
participants – 68 detainees (31 of them participated in a support group) and 68 free citizens. Results
showed that prisoners without the support group showed the highest levels of feelings of
resignation. By contrast, prisoners in the support group were no different from non-prisoners in
terms of resignation stage outcomes, and this beneficial effect of the support group was mediated
by higher levels of perceived social support and psychological flexibility. Overall, this study
suggests that the link between chronic exclusion and the resignation stage could be moderated by
intervening social factors, highlighting the potential benefits of group-based interventions to tackle
the negative consequences of chronic exclusion in chronically excluded populations.
Keywords: social exclusion; prisoners; social support; social cure.
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Can the chronic exclusion-resignation link be broken?
An analysis of support groups within prisons
Introduction
Social exclusion has been broadly defined as the experience of being kept apart from others
physically (e.g., social isolation) or emotionally (e.g., being ignored or told one is not wanted)
(Riva & Eck, 2016). From this perspective, ostracism (primarily characterized by being ignored)
and rejection (being explicitly told that one is not wanted) represent the two main exclusionary
experiences people may face. Social exclusion is a universal phenomenon documented throughout
history in numerous cultures and ages, as well as in many nonhuman animal species (Williams,
2009). People may experience social exclusion on a daily basis when interacting with others; for
instance, they may receive disparaging and devaluing comments or silent treatments (Nezlek et
al., 2012). In recent decades, several empirical studies have investigated the consequences and
processes underlying individuals’ physiological, psychological, and behavioral reactions to social
exclusion (Williams, 2007; DeWall, 2013; Williams & Nida, 2016).
Theoretical Accounts of Social Exclusion
One of the most relevant theoretical models of individuals’ reactions to social exclusion is
Williams’s Temporal Need-Threat Model of ostracism (2009). The author identified a temporal
framework within which individuals’ responses to ostracism develop and distinguished between
the short-term reactions and the long-term detrimental consequences of ostracism.
The first stage of Williams’s model (the reflexive stage) focuses on the immediate reactions
to exclusion. As soon as people realize they are being ostracized, they experience social pain and
a cluster of negative emotions (including sadness and anger). These negative affective states signal
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that something threatening is happening and deserves attention. Moreover, in this stage, ostracism
threatens four fundamental human needs – to belong, to maintain a positive view of the self, to
exert control over one’s actions and environment and to be recognized by others as meaningfully
existing – whose neglect can lead to potentially severe psychological and physical impairment
(Baumeister & Leary, 1995; Steele, 1988; Seligman, 1975; Greenberg et al., 1986). This immediate
emotional reaction has been considered from an evolutionary perspective, as social exclusion puts
human survival at risk by endangering group membership. In the reflective stage that follows, the
victims appraise and evaluate the characteristics of the ostracism experience. According to this
evaluation, people try to satisfy the most threatened needs, reacting either prosocially (if they feel
most threatened in their belongingness and self-esteem) or antisocially (if they mostly need to
reestablish control or be recognized by others). If the individual is able to recover the satisfaction
of the threatened needs, the sense of alarm ceases. However, if exclusion persists over time, the
victims’ resources necessary to recover the satisfaction of their needs become depleted. Thus,
individuals enter the resignation stage, characterized by feelings of alienation, depression,
helplessness, and unworthiness. Crucially, the model assumes that the resignation stage is the only,
inescapable outcome of persistent experiences of social exclusion.
Another influential theoretical account is the Multi-Motive Model of rejection by Smart
Richman and Leary (2009). This model aims to determine the likelihood of a specific reaction to
social rejection based on the individual’s construals of the exclusionary event. The individual
evaluates the circumstances of the rejection experience, including the cost of the rejection, the
possibility of alternative relationships, the expectations of repair, its perceived fairness, and its
chronicity. Then, according to these construals, rejected individuals react aggressively or
prosocially or withdraw from further social interactions (Smart Richman & Leary, 2009). Of
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particular relevance for the present work is the unique association between the chronicity of
rejection and social withdrawal, which appears in keeping with what was suggested by Williams
(2009) in response to chronic ostracism.
Chronic Social Exclusion
The consequences of short-term instances of social exclusion have been investigated in
dozens of studies. Accordingly, researchers have provided reliable empirical support for the first
two stages of Williams’s model. Multiple studies have shown that social exclusion elicits an
immediate reaction characterized by negative emotions (Zadro et al., 2004) and a reduced
satisfaction of basic needs (Williams et al., 2000; Hartgerink et al., 2015). Then, as soon as the
excluded individual can reflect on the meaning of the episode, coping takes place (Williams, &
Nida, 2011).
However, the investigation of the long-term reactions to persistent forms of social
exclusion has received much less empirical attention. We believe that this is due to three main
issues: 1) the temporal definition of chronic or persistent social exclusion, 2) the impossibility of
inducing chronic exclusion in a laboratory setting, and 3) the distinction between subjective
perceptions of social exclusion and objective states of exclusion from others.
Regarding the first issue, we noted that both the Temporal Need-Threat Model (Williams,
2009) and the Multi-Motive Model (Smart Richman & Leary, 2009) frame chronic social exclusion
as an event that persists over a prolonged time but with no indication of a specific duration.
However, the definition of chronic physical pain, which was identified as pain lasting for at least
three months (IASP, 1979), was then applied to chronic social exclusion (Riva et al., 2016; see
also Riva et al., 2014). This work set at three months the minimum duration for an exclusion
experience to be considered chronic. Similarly, Martin and colleagues (2017) investigated the
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long-term effects of rejection from sorority recruitment on young women. The authors found that
women who were rejected from the sorority had lower psychological well-being three months after
the rejection (Martin et al., 2017).
Second, it is obviously not feasible to induce the long-term effect of social exclusion using
an experimental setting. Some experimental studies have applied the life-alone paradigm, which
involves presenting participants with false feedback about their future lives (e.g., telling them they
will end up alone in life), and have shown that exclusion expected in the future causes emotional
numbness. However, researchers have emphasized some limitations of this paradigm, mostly
related to self-presentation concerns (Bernstein et al., 2013).
Finally, the distinction between objective and subjective social exclusion becomes
particularly critical when investigating the consequences of a chronic condition of social exclusion.
Subjective social exclusion refers to someone’s perception of exclusion, regardless of the actual
situation. Objective social exclusion can be defined a priori based on the occurrence of specified
conditions that qualify the exclusionary experience (e.g., being physically kept from others within
the bars of a prison). A subjective (perceived) condition of social exclusion does not always imply
the presence of an actual condition of social exclusion. Previous studies have shown that some
people (i.e., patients with borderline personality disorder) may feel excluded even when they are
objectively included (De Panfilis et al., 2015). However, the available research on chronic
exclusion has mostly been based on self-reports, thus neglecting the differences that may arise in
investigations of the consequences of objective exclusion. Methodologically, one way to address
these issues is by sampling a group of people who experience an objective, a priori definable
condition of chronic exclusion, for example, prisoners, the homeless, or immigrants.
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In this study, we tried to address these issues by focusing on a real-world sample, prisoners,
for whom the objectivity of the exclusion is crystal clear and the temporal dimension (number of
months in prison) can be measured. In prisons, people are kept separate from the rest of society by
a purpose-built facility exactly aimed at segregating them.
Prisons as an Institutional Form of Social Exclusion
Social exclusion allows humans to respond to three fundamental functions for the survival
of their groups: protect, correct, and eject (Hales et al., 2017). When a deviant subject threatens
the integrity of the group – whether physically or symbolically – the group reacts by protecting
itself. The group tries to correct antinormative behaviors by threatening deviant subjects with
exclusion. If these attempts fail, the group recurs to the expulsion of the deviant members. These
processes reach the institutional dimension with prisons and incarceration. Offenders are
threatened with the possibility of being separated from the rest of society within prisons. However,
if this threat is not effective in preventing delinquent behaviors, society reacts by actually
excluding deviant members by confining them within prisons. Protect, correct, and eject – the three
main functions of social exclusion (Hales et al., 2017) – are also the main functions of prisons.
At a social level, inmates’ social exclusion is broad and pervasive. Accordingly, prisons can
be considered to represent, throughout history, the institutionalized and legitimized form of
exclusion within human societies (Zippelius, 1986; Guthrie et al., 2014). Prisons act as the
“ultimate social exclusion” (Jenkins et al., 2005; p. 258), which separates inmates from the outside
world to protect the rest of society from its deviant members and punish and correct nonnormative
behaviors. Prisons involve forcing inmates to reflect on their misconduct through the punitive
experience of social exclusion (Smith, 2008; Hales et al., 2017; Wesselmann et al., 2014). Thus, at
a social level, prisons parallel the interpersonal phenomenon of punitive ostracism, in which an
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agent of socially undesirable behaviors is punished with exclusion in an attempt to correct their
actions (Wesselman, 2011). However, prisoners' experience of social exclusion intersects at
multiple levels of analysis. If the chronic exclusion prisoners that experience at the macrosocial
level can be objectively defined (walls separate them from the rest of society), on the interpersonal
level, the phenomenon is more faceted. Within the prison, inmates may have positive interactions
with guards, relatives, and fellow prisoners (Arrigo & Bullock, 2008), which could act as a buffer
against the negative consequences of prolonged social exclusion (DeWall et al., 2010). However,
inmates may also be exposed to further episodes of rejection and ostracism within the prison walls
because of solitary confinement (Arrigo & Bullock, 2008) or because of negative interpersonal
interactions with other prisoners, as the documented instances of bullying behaviors and ostracism
testify (Richmond, 1978; Ireland, 2000; Hensley, 2000; South & Wood, 2006). Thus, the study of
the psychological consequences of the objective condition of prisoners' chronic social exclusion at
the social level must account for intervening risk and protective factors that can operate at the
interpersonal level within prisons. The presence of support groups in prisons may be one of those
protective factors that shape the development of the negative psychological consequences of the
prolonged exclusion of imprisonment.
Support Groups in Prison
Detention is undoubtedly a radical event in people’s lives that can jeopardize individuals’
mental health (Toch, 1977; Zamble & Porporino, 1988). In recent decades, psychologists have
started conducting social support group programs within prisons. Despite the specificities of each
program, these groups usually aim at promoting psychological well-being among inmates and
providing a supportive social environment for discussing prisoners’ feelings and experiences. The
literature has documented the overall positive effect of support groups in prisons (Katz & Bender,
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1976). More specifically, recent research has focused on providing social support (Biggam &
Power, 1997; Jiang & Winfree, 2006) and facilitating inmates’ awareness of their emotional states
(Pomeroy et al., 2000) as key elements of these interventions. The buffering effect of attending
social support groups leads to a reduction in detention-related stress (Sykes, 1958; Biggam &
Power, 1997), better psychological adjustment to detention (Jiang & Winfree, 2006), and a
reduction in the number of violations of the prison’s rules (Gordon, 1999).
Outside the prison’s walls, the benefits of social support for individuals’ well-being under
many different circumstances, such as helping people cope with a chronic disease (Taylor et al.,
1986) or decreasing psychological distress after a stressful event (Williams et al., 1981), have been
established. Drawing on social identity theory (Tajfel & Turner, 1979), the literature on social cure
has shown that group membership can provide individuals with self-esteem, a sense of meaning
and belonging, and support, which benefit physical and psychological health (e.g., Jetten et al.,
2012). Studies have found that, for example, group membership protects the mental health of
people with multiple sclerosis (Wakefield et al., 2013), prevents postpartum depression in new
mothers (Seymour-Smith et al., 2017), predicts well-being in people recovering from a stroke
(Haslam et al., 2008), reduces the risk of death in retired adults (Steffens et al., 2016), increases
self-esteem in people with autism (Cooper et al., 2017), and increases refugees and immigrants’
well-being (Bobowik et al., 2017).
Within prisons, support groups can provide essential emotional support to inmates. The
possibility of sharing their experience with others in similar situations encourages detainees to
confront their emotions, with a consequent reduction in the avoidance of their emotional state and
a better acceptance of the imprisonment condition, which in turn positively affect their mental
health (Sultan et al., 1986). Indeed, a large body of literature has shown that psychological well-
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being is greatly affected by how individuals approach their inner states rather than how negative
and intense such states are (Bond et al., 2011). Psychological flexibility is defined as the ability to
access one’s feelings, emotions, and thoughts fully and to tailor one’s behaviors and psychological
reactions to them. By contrast, a lack of psychological flexibility makes people unable to withstand
undesirable internal states, pushing them to detach from their personal experience to avoid it. The
resulting outcome is that people who display psychological inflexibility tend to cope with their
emotional states with rigid responses that are not necessarily suited to their subjective experience,
with the possible rebounding effect of increasing psychological distress (Bond et al., 2011; Tyndall
et al., 2018; Wenzlaff & Wegner, 2000).
The present study
The present research investigates the link between chronic social exclusion and the
resignation stage theorized in Williams’s model (2009) by comparing a sample of prisoners –
experiencing a condition of objective chronic social exclusion – with a general population of
nonprisoners. The research was conducted in Northern Italy’s two main prisons, which apply
dynamic surveillance, namely, the possibility for prisoners to exit their cells during the daytime
and move within their section. This regulation also allows inmates to access outside areas (i.e.,
courtyards) and attend specific activities (e.g., art workshops, educational courses, sports
activities). In both institutions, a weekly support group led by psychologists was in place as part
of these activities.
The main aim of the present work was to test the prediction that chronic exclusion leads to
a psychological state of resignation. The second aim focused on the role of a support group within
the prison in buffering the chronic exclusion-resignation link. We elaborated two main hypotheses.
First, in line with the available theoretical accounts (Williams, 2009; Smart Richman & Leary,
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2009), we expected that prisoners would show higher levels of resignation than free citizens (HP1).
Second, possibly extending the prediction made in the theoretical accounts of chronic exclusion
(Williams, 2009; Smart Richman, & Leary, 2009), we expected that the prisoners who did not
attend support group activities would report higher levels of resignation compared to those who
attended such activities (HP2).
Given that the support group intervened in the psychological condition of the inmates by
potentially providing social support and increasing the psychological acceptance of their life
condition, we then tested whether the improvement of the inmates’ psychological condition from
participating in the group was due to (HP3) an increased perception of social support and (HP4)
increased psychological flexibility. Although a broad body of evidence has shown the positive
effects of psychological flexibility on well-being, to our knowledge, no previous study has
examined the role of psychological inflexibility as a possible intervenient factor influencing
prisoners’ well-being. However, given the extensive literature attesting to its primary role in
affecting individuals’ well-being (see for a review Cheng et al., 2014), it is reasonable to
hypothesize that the emotional support provided by the support groups could foster prisoners’
perception of social support and psychological flexibility, which in turn could positively affect
their psychological health.
Method
Participants
Based on a snowballing sampling, we recruited a total sample of 136 participants,
subdivided as follows. The data are stored at the OSF platform at the following anonymized link
(https://osf.io/sqdgf/?view_only=c0d1b2e9ff014b49be293d53c20141c0). Based on this sample of
136 participants subdivided in three groups, a sensitivity analysis for one-way ANOVA with a
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conventional power of β = .80 and α = .05 showed that the achieved sample size allowed us to
reliably detect effect sizes greater than medium (i.e., above f = 0.269, corresponding to ηp2 =
0.067).
Prisoners
Prisoners were recruited in two major prisons in the Milan area - Italy (Opera and Bollate).
Sixty-eight inmates (11 from the Institute of Opera and 57 from the Institute of Bollate) composed
the final sample of prisoners. All the participants were male and their ages varied between 20 and
66 years (M = 43.77; SD = 10.45). Regarding education, 7.4% completed elementary school, 47%
secondary school, 39.7% high school, and 4.4% University.
They had already spent on average 84.68 months in prison (SD = 81.74, range = 4 – 439
months) and, except for six persons sentenced to life, on average they had to spend 72.26 remaining
months of detention (SD = 53.55, range = 5 – 240 months). The 13.1% did not receive visits
regularly, whereas the others received a median of four visits per month (range = 1 - 8). All of the
prisoners were Italian but for two Moroccans, one Albanese, one Brazilian, one Argentinian-
Peruvian, and three unspecified.
Out of 68 prisoners, 31 were part of a support group within the prison.
Nonprisoners
The sample of nonprisoners included 68 Italian men, aged from 22 to 63 years old (M =
42.72, SD = 11.11). Regarding education, 10.3% completed elementary school, 42.6% secondary
school, 42.6% high school and 4.4% University. A screening question for this group was: ‘Have
you ever been imprisoned?’. Participants were selected if they did not have a history of
imprisonment.
Procedure
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Data were collected using self-reported questionnaires. The questionnaires were sent in
paper format to the referent of the prisoners – an inmate that coordinate the formal relationships
between the other inmates and the management officers of the prison – of each of the institute
sections. Then, the referents delivered the questionnaires to the other convicts willing to participate
in the survey. To preserve the anonymity and to avoid any possible form of coercion, prisoners
completed the questionnaire without any supervision. There were no benefits for the prisoners nor
their referents in participating in this study, and this was done to encourage only spontaneous forms
of participation. After completion, the questionnaires were collected by the referents and delivered
to the researchers who manually entered the data on an excel file. In this way, we could recruit the
prisoners both participating at and outside the support group. The support group was composed of
free-citizen volunteers that encouraged prisoners to share their detention-related experiences and
to support each other with emotional and social support. These interventions also aimed at
promoting socialization among the prisoners, and between the prisoners and the free citizens. For
instance, one of the activities consisted in organizing a theatre drama, where both the citizens and
the convicts acted together in the play for an audience made of both inmates and prisoners.
Situations like this fostered the creation of new social connections among prisoners, the different
actors, and with the external audience. Moreover, once a week, the group met in a structured
moment of emotional sharing (i.e., circle time) where the psychologists, prisoners, and volunteers
discussed, sat in a circle, about the feelings, thoughts, and events related to the imprisonment. This
aimed at promoting the acceptance of the condition of the imprisonment, exploring feelings, and
strengthening the beliefs about one's worthiness, thus alleviating inmates’ psychological struggles.
We used an online version of the same questionnaire used with prisoners to recruit free-
citizens (see the Appendix for the full list of the items). This version was delivered online via
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different sources (e.g., Facebook), using a snowball sampling methods, to potential participants
with socio-demographic characteristics (in terms of gender, age, and educational level) similar to
those of the group of the prisoners. The Ethical Committee of the University of Milano-Bicocca
approved the research protocol.
Measures
Need-threat
We used an adjusted version of the Need-Threat Scale (Williams, 2009) to assess the
exclusion-related need threat. We selected one item for each of the four fundamental human needs:
belonging (e.g., ‘I feel cut out of relationship’), self-esteem (i.e., ‘I feel good about myself’),
control (i.e., ‘I feel to be in control of the events’) and meaningful existence (i.e., ‘I feel invisible’).
We also measured the feelings of being excluded and ignored (i.e., ‘I feel excluded,’ ‘I feel
ignored’). After recoding the reverse items, all the six items were rated on a 5-point Likert scale
(1= totally disagree to 5= totally agree) with high scores indicating more threat of basic needs
(Cronbach’s α = .81).
Negative emotions
We adapted the Rejected-Related Emotions Scale (Buckley et al., 2004) to assess the
participant’s level of exclusion-related negative emotions. Specifically, we selected one item for
each of the emotional cluster assessed in the original scale: anger, anxiety, sadness, hurt, and
happiness (reversed). Each of the five items was rated on a 5-point scale (1= totally disagree to 5=
totally agree). Higher scores indicated higher negative emotions (Cronbach’s α = .77).
Psychological inflexibility
The Acceptance and Action Questionnaire-II (AAQ-II; Bond et al., 2011) assessed the
psychological inflexibility and experiential avoidance. The scale consisted of 7 items (e.g., ‘I am
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afraid of my feelings,’ ‘Worries get in the way of my success’) rated on a 5-point Likert scale (1=
totally disagree to 5= totally agree). The higher the score, the more the participant presented a rate
of psychological inflexibility (Cronbach’s α = .83).
Social support
The Social Provision Scale (SPS; Curtona & Russel, 1987) assessed the participants’
perception of social integration and emotional support (e.g., ‘I don’t have a close relationship with
other people,’ ‘I wouldn’t talk easily about my problems with no one’). The 10 items of the scale
were on a 5-point Likert scale (1= totally disagree to 5= totally agree). The higher the scores, the
more the participants perceived a lack of social support (Cronbach’s α = .89).
Resignation stage measures
We selected four scales to assess the four outcomes that characterize the resignation stage.
Unworthiness. We selected seven items from the Self-Esteem Scale (Rosenberg, 1965) to
assess participants’ self-worthiness. These seven items (e.g. ‘After all I think I’m a failure,’
‘Sometimes I feel useless’) were rated on a 5-point Likert scale (1= totally disagree to 5= totally
agree). The response scale was recoded so that higher scores indicate higher levels of unworthiness
(Cronbach’s α = .77).
Depression. The Depression Anxiety Stress Scale 21 (DASS-21; Henry & Crawford, 2005)
measured the level of depression, anxiety, and stress with 21 items. We used only seven items
concerning depression (e.g., ‘I couldn’t seem to experience any positive feeling at all,’ ‘I felt that
life was meaningless’), and the participant had to rate each item on a 5-point Likert scale (1=
totally disagree to 5= totally agree). Higher scores indicate higher feelings of depression
(Cronbach’s α = .81).
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Helplessness. As in previous studies measuring resignation (e.g., Riva et al., 2016;
Marinucci & Riva, 2020), helplessness was measured via items from the Beck Hopelessness Scale
(Beck, 1974). It measured participants’ future-oriented lack of motivation (e.g., ‘It’s useless to try
to get what I want because probably I’ll fail’) and negative feelings about the future (e.g., ‘My
future seems uncertain and unclear’). Each of the seven items selected was rated on a 5-point
Likert scale (1= totally disagree to 5= totally agree) with higher scores indicating higher
helplessness (Cronbach’s α = .72).
Alienation. The Sense of Belonging Instrument (SOBI; Hagerty & Patusky, 1995) assessed
participants’ feelings of relatedness to others. We selected seven items concerned participants’
experiences of isolation (e.g., ‘I’m worried because I feel I have no place in this world,’ ‘I don’t
feel like I’m part of society’). Each item was rated on a 5-point scale (1= totally disagree to 5=
totally agree). Higher scores indicated higher feelings of alienation (Cronbach’s α = .74).
Resignation overall index. Considering the high internal consistency (Cronbach’s α = .92)
of the items measuring the resignation outcomes, we created an overall index of resignation
consisting of the mean of all the items from the four scales concerning the resignation stage:
alienation, unworthiness, helplessness, and depression.
Socio-demographic variables
Participants were also asked to provide some socio-demographic information. Specifically,
we required to know the gender, age, marital status, nationality, education, and job title of each
participant. Also, only for incarcerated participants, some additional information was requested
concerning their experience of detention, including the number of months spent in the current
detention, the months left to spend in the prison, and the number of visits from free citizens
received monthly.
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Results
Group comparisons
Initially, we compared the group of the inmates with the control group to investigate the
effect of detention on the psychological consequences of social exclusion, on the psychological
inflexibility and the perceived lack of social support. The groups did not differ on age (t(130) =
0.56; p = .58) or education (X2(3,1) = 0.54; p = .91). The results of t-tests for independent samples
showed that the prisoners reported higher need threats (t(133) = 2.18, p = .031, d = 0.37; prisoners:
M = 2.58, SD = 0.91, non-prisoners: M = 2.26, SD = 0.81) and negative emotions (t(134) = 4.37,
p < .001, d = 0.75; prisoners: M = 3.11, SD = 0.84, non-prisoners: M = 2.46, SD = 0.89) when
compared to non-prisoners. However, the two groups did not differ on the outcomes associated
with the resignation stage, as well as on the overall index of resignation, on the psychological
inflexibility and the perceived lack of social support (ps > .07).
Then, we tested if the participation in the support group protected from the negative
psychological effects of detention and affected the psychological inflexibility and the perceived
lack of support. We analyzed the group differences conducting a series of one-way ANOVAs
setting the factor categorizing prisoners not taking part in the support group, prisoners participating
in the support group and free citizens as the independent variable and all the psychological
constructs measured as dependent variables.
We found a recurrent pattern of results (see Table 1 for descriptive statistics): the prisoners
participating in the support group and the free citizens presented non-significant differences in the
considered variables. However, those two groups showed significantly better psychological
outcomes than the group of prisoners who did not participate in the support group. This pattern
occurred in the need threats (F(2, 132) = 7.81, p = .001, ηp2 = .106), feelings of alienation (F(2,
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133) = 5.49, p = .005, ηp2 = .076), depression (F(2,133) = 7.62, p = .001, ηp2 = .103), and overall
index of resignation (F(2,133) = 7.16, p = .001, ηp2 = .097). We also found a significant difference
between the three groups in the negative emotions (F(2,133) = 12.50, p < .001, ηp2 = .158), in the
psychological inflexibility (F(2,133) = 3.39, p = .037, ηp2 = .049), and in the perceived lack of
social support (F(2,133) = 3.39, p = .037, ηp2 = .049), where the free citizens had less negative
emotions, inflexibility, and perceived lack of support than the group of convicts who did not
participated at the support group. Finally, the prisoners attending the support group had lower score
of helplessness (F(2,133) = 3.87, p = .023, ηp2 = .055) and unworthiness (F(2, 133) = 4.14, p =
.014, ηp2 = .062) than the prisoners without the support group.
Mediation analyses
We then tested if the buffering effect of the participation at the support group on the
resignation stage was mediated by the psychological inflexibility and the perceived lack of support.
In particular, we tested whether participation at the support group would benefit inmates via
reducing psychological inflexibility and perceiving a lack of social support, which in turn would
result in lower psychological resignation.
We used a bootstrapped procedure (N of bootstrap samples = 5000) to estimate the direct,
indirect, and total effect of the predictor on the outcome controlled for the mediators (Process
Macro for SPSS, version 3.1; Hayes, 2017). We ran two separate mediation models1 to test the
mediating effect of the psychological inflexibility and the perceived lack of social support,
respectively. In both models, the group (coded as 0 = prisoners without the support group, 1 =
prisoners with the support group) was the predictor and the overall index of resignation the main
outcome.
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In the first model, we observed that the participation at the support group was associated
with lower levels of psychological inflexibility (b = -0.43 SE = 0.21, t(66) = -2.05, p = .045) and
lower levels of resignation (b = -0.43 SE = 0.15, t(65) = -2.98, p = .005), and the psychological
inflexibility was positively related to the resignation stage (b = 0.45, SE = 0.08, t(65) = 5,47, p <
.001). We found a significant indirect effect of the group on the resignation stage via the
psychological inflexibility (b = -0.20 95%CI [-0.393 -0.005]), thus supporting the mediation
hypothesis (see Figure 1).
Similarly, in the second model we found that the participation at the support group was
negatively related to the resignation stage (b = -0.45, SE = 0.15, t(65) = -2,97, p = .004) and to the
perceived lack of support (b = -0.40, SE = 0.20, t(66) = -2.01, p = .048), and the lack of support
was associated with higher levels of resignation (b = 0.45, SE = 0.09, t(65) = 5.01, p < .001). The
indirect effect via the perceived lack of support was significant (b = -0.18, 95%CI [-0.395 -0.008])
(see Figure 2). In conclusion, taking part in the support group reduced inmates’ psychological
inflexibility and the perception of a lack of social support, which in turn resulted in lower feelings
of resignation.
General Discussion
The present study examined the long-term impacts of social exclusion. To do so, we
considered the detention of inmates as an objective case of chronic social exclusion. The results of
the comparison between prisoners and free citizens showed that prolonged forms of social
exclusion are associated with higher threats to fundamental needs and negative emotions.
Focusing on the potential role of support groups within prisons, we found that only the
prisoners who were not attending a support group reported a higher level of feelings of resignation
(i.e., alienation, depression, unworthiness, and helplessness). Therefore, the predictions based on
20
the available theoretical accounts of chronic social exclusion (see Williams, 2009; Smart Richman,
& Leary, 2009) were supported only when we considered inmates not taking part in a support
group. In contrast, the inmates who participated in a support group showed levels of resignation
that were not different from those of the general population. In essence, the support group nullified
the adverse outcomes that should be associated with an objective condition of chronic social
exclusion.
Thus, on the one hand, our results supported the existing theoretical models (Williams,
2009; Smart Richman, & Leary, 2009). However, on the other hand, they provided boundary
conditions for the existing models, showing that it is possible to undergo an objective experience
of chronic social exclusion without ending up in resignation. These results highlighted that
marginalized social groups that experience a persistent objective condition of social exclusion,
such as prisoners who are confined and segregated from the rest of society, may be subject to
intervening factors at the interpersonal level (the presence of a supporting group in prison), whose
proximal processes (perceived social support and group-induced psychological flexibility) can
provide a buffer against the development of the resignation stage. Moreover, the present results
are consistent with a previous study showing that interpersonal social connections with majority
and minority group members could moderate the consequences of chronic social exclusion
(Marinucci & Riva, 2020). Therefore, in view of the present results together with the most recent
literature, resignation does not seem to be the inescapable outcome of social exclusion envisaged
by theoretical models, given that research has begun to show that more proximal factors can
prevent or aggravate the development of resignation.
These findings are also consistent with previous research showing a beneficial effect of
support groups on wellbeing (Katz & Bender, 1976). In particular, they align with the social cure
21
literature (e.g., Haslam et al., 2009; Jennen et al., 2012), emphasizing the positive effects that
membership and identification in social groups have on individual health. The core assumption of
the social cure literature is that group membership can provide people with self-esteem, meaning,
relatedness, a sense of purpose, and efficacy in life, which in turn positively affect people’s health
and well-being (Jetten et al., 2017). Accordingly, in the context of the present study, participation
in the support group in prison may have provided inmates with an additional source of group
membership, with the derived beneficial implications in counteracting the burden of social
isolation and exclusion from confinement. The support group may have fostered a sense of
similarity, relatedness, worthiness, and “existential security” (Durkheim, 1951) among inmates
due to the sharing of their experiences and identification in the group, thus buffering the negative
effects of chronic social exclusion.
In our study, we explored two potential mechanisms underlying the benefits of the support
group. On the one hand, participation in the support group increased the perception of social
support, which in turn resulted in lower psychological resignation. These findings support what
has been observed in support groups both inside (Jiang & Winfree, 2006; Sykes, 1958; Biggam &
Power, 1997) and outside prisons (Williams et al., 1981), namely, that attending support groups
has favorable repercussions for wellbeing. Indeed, group ties can provide various types of social
support, such as emotional support (care, acceptance and sympathetic listening), instrumental
support (practical help and material aids), and informational support (information, advice, and
guidance; House, 1983; Sani, 2012). Moreover, researchers have found that the perceived
availability of social support has stronger benefits than the actual social support received (Finch
et al., 1999; Helgeson, 1993). Some have argued that perceived support might enhance the
22
perceived ability to cope with stressful events, which in turn would lessen the perceived harshness
of the events (Thoits, 1986; Uchino et al., 1996; Sani, 2012).
On the other hand, the support group improved inmates’ psychological flexibility, which
could have buffered prisoners from falling into the resignation stage. In line with previous research
(Bond et al., 2011; Wenzlaff & Wegner, 2000; Tyndall et al., 2018), these findings suggest that
psychological flexibility can have a protective role in reducing the negative consequences of
stressful conditions. These results seem to be in line with other nonclinical interventions aimed at
fostering psychological flexibility in different contexts. In a study with preschool teachers, Biglan
and colleagues (2013) delivered a nonclinical intervention aimed at increasing the acceptance of
unpleasant feelings and the sharing of ways of coping with stress and difficult working
experiences, among other psychological skills, which increased participants’ flexibility and in turn
their well-being. Similarly, it is possible to argue that sharing emotional experiences in support
groups led the prisoners to face their inner states and emotions more readily, enhancing their ability
to accept thoughts and feelings and consequently to respond to them more adaptively. It is also
possible to speculate that the emotional sharing with support group members in the dysphoric
context of imprisonment could increase the sense of intense social bonding with the group
(Newson et al., 2016; Whitehouse et al., 2017), which in turn (see the social cure literature; e.g.,
Jetten et al., 2012) could result in an improvement of psychological health.
Limitation and Future Research
Given the challenge of identifying and sampling a population that can be defined as
objectively, chronically excluded, this study was among the first to investigate the relationship
between chronic social exclusion and the resignation stage in an empirical setting. These results
offer initial evidence of the link theorized by Williams (2009) and Smart Richman and Leary
23
(2009) and can inform future research looking at factors moderating the link between chronic
exclusion and resignation and withdrawal outcomes.
Perhaps the most important finding of this research is that resignation is not an inescapable
outcome associated with experiences of chronic social exclusion. Further studies need to take into
account both contextual and individual characteristics to better understand which factors influence
the experience of resignation. As research has shown a longer recovery time after a short-term
experience of ostracism among anxious subjects (Zadro et al., 2006), it could be useful to
investigate whether anxiety also intervenes in chronic conditions. A more in-depth study of
personality traits in excluded subjects should explain how individual differences could provide a
buffer against the consequences of marginalization, contributing to a more sophisticated
articulation of Williams’s (2009) model. By showing that the exclusion-resignation link can be
moderated and mediated by intervening factors, this work informs future research of the need to
identify other potential variables that can further prevent or exacerbate the development of
resignation in chronically excluded populations.
Moreover, further research should examine the social context of exclusion, for example,
focusing not only on support groups but also on already existing groups (e.g., sports groups,
religious groups) as a potential help for chronically excluded individuals. However, to allow for
generalization of these findings, future studies need to replicate them among other chronically
excluded subjects, such as the homeless, migrants, and other institutionalized groups, such as older
adults and people with mental illness. The comparison with other segregated groups could help to
overcome the peculiarity of each specific sample. Additionally, future studies can investigate the
role of within-prison support groups for inmates’ life transitions outside prison. Findings from
several studies indicate that stressful life transitions can severely impair well-being, especially
24
when the transition implies a loss of existing social identities or struggles in making new ones
(e.g., Praharso et al., 2017; Jetten et al., 2009; Haslam et al., 2008). Research can further investigate
the potential benefits of the social connections established with inmate or free-citizen support
group members in providing a sense of identity continuity as well as the resources that these groups
can provide for building new social identities once individuals are out of prison.
Care must be taken with the presented results in view of the following limitations. First,
although the effect sizes of the main findings were above the sensitivity analysis threshold, our
sample size is modest, composed only of men, and with no perfect balance of each condition. In
Italian prisons, women are approximately 4.2% of the whole population (Ministero di Giustizia,
2016), which makes it quite difficult to balance the gender of the sample. However, it is
challenging to access and collect empirical data from chronically excluded subjects, particularly
from prisoners, due to their physical segregation. Nevertheless, future studies need to try to
replicate these findings considering the characteristics of women in incarceration (Byrne &
Howells, 2002; Douglas et al., 2009). Moreover, given that it was a correlational study and the
support group had already been implemented, we could not accurately measure or monitor other
potential psychological processes that were enhanced by participation in the support group. Future
studies should better account for the psychological functions and processes targeted by the
intervention, thus permitting the researchers to control for the potential processes targeted.
Since we could not randomly assign participants to the condition of group participation,
our findings are open to alternative explanations. We found that the support group led to a reduction
in resignation symptoms via improved psychological flexibility and perceived social support.
However, these results must be taken with caution for two reasons. First, the limited sample size
of prisoners who participated and did not participate in the support group permits us to claim only
25
that we present initial evidence of these mediational effects. Future studies are needed to replicate
them using more powered statistical tests, which would strengthen their reliability and allow for
more conclusive assertions about the role of perceived support and psychological flexibility in
support groups for inmates. Second, the cross-sectional design of the study did not allow us to rule
out the alternative explanation that prisoners who participated in the support group were already
less resigned and more psychologically flexible (i.e., self-selection bias). Thus, we cannot exclude
the possibility that participant self-selection affected our results, and future research should use
more sophisticated methodologies (e.g., longitudinal studies assessing the causal effects of group
participation) to control for this potential bias. In addition to perceived support and psychological
flexibility, given the key role that social identification processes may have had in the buffering
effect of the support group, future studies should more directly measure prisoners’ social
identification with the support groups. Despite these limits, the present results align with a strong
strand of the psychological literature (e.g., Jetten et al., 2017), further highlighting the potential
benefits of social groups and group membership for marginalized populations.
Conclusion
This work showed that the negative effects of the chronic social exclusion experienced by
prison inmates could be counteracted via the implementation of effective support groups aimed at
providing emotional and social support to prisoners. From a theoretical perspective, these findings
contribute to supporting and extending existing theoretical models of social exclusion (Williams,
2009; Smart Richman, & Leary, 2009), highlighting that the resignation stage can be linked with
prolonged exclusion but is not inevitable and can be moderated by intervening social and
individual factors. In addition, the present results contribute to a better understanding of the role
of psychological support within prisons and inform psychologists in the development of more
26
tailored and effective interventions to address the negative repercussion of imprisonment and
evolve from a punitive to a rehabilitative ideal of detention (Phelps, 2011).
27
Footnotes
1 Given the modest size of the samples with and without the support group, we opted to
report two simple separate mediation models that did not allow to account for the covariance of
the mediators. However, we checked the robustness of the results by running a more complex
mediation model simultaneously accounting for the two mediators, and the results were confirmed
(indirect effect via psychological flexibility: b = -0.09 95%CI [-0.173 -0.015]; indirect effect via
perceived lack of support: b = -0.05 95%CI [-0.116 -0.008]).
28
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