Buddhism in war: A study of cause and effect from Sri Lanka

In this article, I explore two attitudes towards war present among Buddhists in contemporary Sri Lanka: support for an all‐out military victory over the Liberation Tigers of Tamil Eelam (LTTE) and support for a ceasefire followed by a negotiated settlement. After a phenomenological presentation of the two approaches, I turn to the factors that have conditioned them. I argue that canonical narrative is drawn on both to support the war and to reject it and then look at more recent colonial history to provide further data, particularly to the dynamic undergirding Buddhist support for war. In the nineteenth century, under British rule, one significant ‘other’ for Sri Lankan Buddhists was the Christian. A pattern of spirited defence developed in the face of what was seen as humiliation and betrayal at the hands of Christians. This pattern, the paper suggests, can throw light on responses in the present to the very different ‘other’, the LITE.     

PTSD symptoms among tsunami exposed mothers in Sri Lanka: the role of disaster exposure,culturally specific coping strategies,and recovery efforts

Background and objectives: Women in Sri Lanka have been uniquely exposed to a complex and protracted set of stressors stemming from a civil war conflict spanning over 25 years and the tsunami which struck Southeast Asia in 2004. This study investigates coping strategies and their association with trauma-related symptoms of tsunami-exposed mothers in Sri Lanka at two time points.

Design: Data for this study come from surveys administered in two waves of data collection to investigate both mothers’ and adolescent children’s post-tsunami mental health in early 2005, three months after the tsunami struck, and again in 2008, three years later.

Methods: Latent-variable structural equation modeling was used to test the study hypotheses among 160 tsunami-affected mothers in the Polhena village, Matara district, Sri Lanka.

Results: Among the various coping strategies examined, the use of cultural rituals as well as inner psychological strength was associated with lower levels of posttraumatic stress symptoms. In contrast, passive religious beliefs were associated with greater posttraumatic stress levels.

Conclusions: The results of this study reveal the differential associations of various coping strategies including rituals used by mothers exposed to the tsunami in Sri Lanka and their posttraumatic stress symptom levels.     

War and disaster in Sri Lanka: Implications for widows' family adjustment and perception of self‐efficacy in caring for one's family

The data for this study were collected in 2014 from widows in Eastern Sri Lanka whose spouses died in the civil war, tsunami, or from health‐related problems. Conservation of resources (COR) theory was used as a lens to examine the extent to which war and tsunami‐related damages and family problems predict variation in social support, family adjustment and a perception of self‐efficacy in caring for one's family as reported by widowed women. We also investigated whether social support from the community and social support from family and friends mediated those relationships. Results of a path model fit to the data suggested variation in family adjustment to be negatively predicted by war‐related family problems and positively predicted by the social support of friends and family. Additionally, a sense of self‐efficacy in caring for one's family was found to be inversely predicted by war‐related family problems and tsunami damages. Clinical, social and theoretical implications are discussed as well as directions for further research.     

Taking liberties and making liberty: religious bounding and political violence in Sri Lanka

This paper argues that the relationship between religion and violent politics is best understood through a focus on religious practice. The case study of the Tamil Catholic Church within Sri Lanka's civil war is presented against a backdrop of Buddhist monk participation in violent insurgency decades earlier. The discrete cases evidence a common preoccupation with management of physical borders and discursive boundaries as actors seek to reproduce themselves and their work as legitimately ‘religious’. Despite relying on remaining ‘pure’ from the dirty political realm, in practice religion is bound to social action and reproduced through the violent circumstances it engages.     

Examining associations among factor-analytically derived components of mental health stigma, distress, and psychological flexibility

Mental health stigma can be detrimental not only for the recipient, but also for the stigmatizer. As mental health stigma is often conceptualized as a multidimensional construct, Study 1 first examined the factor structure of mental health stigma as assessed by the Stigmatizing Attitudes-Believability (SAB; Masuda, Price, Anderson, Schmertz, & Calamaras, 2009). Study 2 investigated differential relations between the factor-analytically derived components of mental health stigma and psychological distress and psychological flexibility. Results of Study 1 revealed that mental health stigma consisted of two related, yet separable components: Exclusion and Course/Origin. The Exclusion component was characterized by negative emotions and cognitions associated with an increased desire for social distance. Course/Origin was marked by pessimistic views toward treatment prognosis and recovery. Results of Study 2 suggested that these two components have differential associations with psychological distress and flexibility. The Course/Origin component of stigma, but not Exclusion, was associated with psychological distress of the stigmatizer. Furthermore, this association was fully mediated by lower levels of psychological flexibility. These findings suggest the importance of conceptualizing mental health stigma multidimensionally.     

The stigma of mental illness: Explanatory models and methods for change

For people with mental illness, diminished quality of life and loss of personal goals does not result solely from the symptoms, distress, and disabilities caused by their psychiatric disorder. Quality of life and personal goals are also hindered by people who embrace the stigma that accompanies mental illness and mental health care. This paper reviews evidence of the impact of mental illness stigma and strategies for seeking to ease its impact. To achieve these goals, we (a) describe the ways in which stigma harm people with mental illness, (b) summarize models that explain the development and maintenance of these stigmatizing effects, and (c) review strategies that have been shown to decrease the impact of stigma. Concerns about stigma are on the political agendas of many mental health advocacy groups. It has recently also become the focus of extensive research. Our goal in this paper is to balance the practical concerns raised by mental health advocates against data that support or contradicts specific assertions.     

Migrants straddling the “here” and “there”: Explorations of habitus and hybrid identities among Sri Lankan migrants in New Zealand

Migrant settlement is of particular interest to the field of psychology due to a notable increase in the movement of people over the past few decades. This article explores the ways in which Sri Lankan migrants in New Zealand establish a sense of continuity between the host nation and country of origin. The theoretical framework for this research is informed by elements of ethnographic and indigenous research. We provide a rich understanding of migrant experiences that foregrounds the agency and resilience of migrants, and acknowledges the complexities of the notion of identity and migrant settlement. We explore complex, fluid, and hybrid cultural identities as experienced by Sri Lankan migrants and their negotiations of space and place, material practices, and objects of significance, such as an educational institution, antique dinnerware, and furniture with colonial origins. The present research thereby, argues for the need to acknowledge both the historical and current contexts that shape migrants' sense of habitus and cultural identities.     

The interaction between baseline trait anxiety and trauma exposure as predictor of post-trauma symptoms of anxiety and insomnia

In this study a prospective design was used to investigate the interaction between baseline trait anxiety and exposure to traumatic situations on post-trauma symptoms of anxiety and insomnia in a sample of Swedish peacekeeping soldiers serving in Kosovo. The result showed that pre-trauma trait anxiety interacted with exposure to traumatic situations predicting a higher post-trauma distress. Further, baseline trait anxiety and baseline symptoms of anxiety and insomnia predicted post-trauma symptoms of anxiety and insomnia. The results support a diathesis stress model in which high trait anxiety interacts with trauma exposure in the elicitation of anxiety-related distress but the study needs to be replicated before further conclusions can be drawn.     

Task-shifting to improve the reach of mental health interventions for trauma patients: findings from a pilot study of trauma nurse training in patient-centered activity scheduling for PTSD and depression

ABSTRACT

Despite high rates of posttraumatic stress disorder (PTSD) and depression among traumatically injured patients, engagement in session-based psychotherapy early after trauma is limited due to various service utilization and readiness barriers. Task-shifting brief mental health interventions to routine trauma center providers is an understudied but potentially critical part of the continuum of care. This pilot study assessed the feasibility of training trauma nurses to engage patients in patient-centered activity scheduling based on a Behavioral Activation paradigm, which is designed to counteract dysfunctional avoidance/withdrawal behavior common among patients after injury. Nurses (N = 4) and patients (N = 40) were recruited from two level II trauma centers. A portion of a one day in-person workshop included didactics, demonstrations, and experiential activities to teach brief intervention delivery. Nurses completed pre- and posttraining standardized patient role-plays prior to and two months after training, which were coded for adherence to the intervention. Nurses also completed exit interviews to assess their perspectives on the training and addressing patient mental health concerns. Findings support the feasibility of training trauma nurses in a brief mental health intervention. Task-shifting brief interventions holds promise for reaching more of the population in need of posttrauma mental health care.     

The gifts of allurement: anti-conversion legislation,gift-giving,and political allegiance in South Asia

ABSTRACT

The last decade has seen an escalation of various acts of anti-conversion legislation in Nepal, Sri Lanka, and in different states of India. Several scholars comment that the upsurge of anti-conversion legislation can be linked to the ascension of religious nationalism in India and Sri Lanka, yet recent trends indicate that such laws are also proposed by moderate political forces. What is notable about this anti-conversion legislation is that it criminalizes ‘improper’ conversions along the lines of force, fraud, and allurement/inducement. While Article 18(2) of the International Covenant of Civil and Political Rights (ICCPR) protects against coercion, and thus forcible conversions, and while the concepts of force and fraud are already covered by the penal codes of the respective countries, the remaining element of controversy of anti-conversion legislation is that of allurement and/or inducement. ‘Allurement’ is defined as the offer of any temptation for the purpose of converting a person professing one religion to another religion, in the form of: “(i) any gift or gratification whether in cash or kind, (ii) a grant of any material benefit, whether monetary or otherwise, (iii) the grant of employment or grant of promotion in employment” (Owens 2006–2007, 337). Yet, despite critical remarks from the UN Special Rapporteur on the Freedom of Religion or Belief, Asma Jahangir, that these anti-conversion proposals are vague in their formulations and may lead to religious persecution, the legislative attempts are persistent in their demand to criminalize the allegedly religious gifts of allurement. This article argues that the rationale behind anti-conversion legislation stems from a threefold objective: (1) the dislike of gifts from the religious Other in particular and proselytization in general, (2) legislation as a regulating mechanism of majority religious bodies vis-à-vis religious minorities, (3) anti-conversion laws demanding the complicity of the state in relation to the majority religions, accentuating state patronage as a tacit form of state religion bill.     

Social network as a moderator in the relation between trauma exposure and trauma reaction: a survey among UN soldiers and relief workers

Social network as a moderator between trauma exposure and post-trauma symptomatology was studied. Two samples--relief workers and UN soldiers--were assessed on trauma exposure, social network and three dependent measures related to post-trauma reactions. Regression analysis and interaction plots were used to determine the presence of interaction effects between trauma exposure and social network. All four network variables moderated the relationship between trauma exposure and post-trauma reactions among relief workers, while among UN soldiers only two such buffer effects were found. Furthermore, among UN soldiers one of these interaction effects was reversed, indicating social support to be important for those low on trauma exposure, while among relief workers support was important in the high-exposure condition. The results indicate a difference with respect to the importance of social network as a moderator between groups exposed to different kinds of war trauma. Differences in motivational systems may also exist. However, further research will have to establish this.     

The influence of culture on disaster mental health and psychosocial support interventions in Southeast Asia

Southeast Asia (SEA), which has borne the brunt of some of the most severe natural disasters in the past decade, has unfortunately, been largely under-represented in the world literature on disaster mental health. This article describes cultural factors that may inform the design and conduct of disaster-related mental health psychosocial support (MHPSS) interventions. Specifically, it discusses cultural nuances in emotional expression, shame, power distance, collectivism, and spiritual beliefs and their implications on providing post-disaster psychosocial interventions. It describes the MHPSS interventions implemented in the region using the Johns Hopkins Perspectives Model of Disaster Mental Health categories of resistance, resilience and recovery. Given the challenges on the delivery of MHPSS, there is a need for evidence-based interventions and to ensure that disaster responders in SEA understand the cultural factors that impact the delivery of MHPSS interventions.     

Unemployment in Iraqi refugees: The interaction of pre and post‐displacement trauma

Previous refugee research has been unable to link pre‐displacement trauma with unemployment in the host country. The current study assessed the role of pre‐displacement trauma, post‐displacement trauma, and the interaction of both trauma types to prospectively examine unemployment in a random sample of newly‐arrived Iraqi refugees. Participants (N = 286) were interviewed three times over the first two years post‐arrival. Refugees were assessed for pre‐displacement trauma exposure, post‐displacement trauma exposure, a history of unemployment in the country of origin and host country, and symptoms of posttraumatic stress disorder (PTSD) and depression. Analyses found that neither pre‐displacement nor post‐displacement trauma independently predicted unemployment 2 years post‐arrival; however, the interaction of pre and post‐displacement trauma predicted 2‐year unemployment. Refugees with high levels of both pre and post‐displacement trauma had a 91% predicted probability of unemployment, whereas those with low levels of both traumas had a 20% predicted probability. This interaction remained significant after controlling for sociodemographic variables and mental health upon arrival to the US. Resettlement agencies and community organizations should consider the interactive effect of encountering additional trauma after escaping the hardships of the refugee's country of origin.     

The unwelcome child and his dreams: reconceptualization of dreaming in trauma

Based on the concepts of Sándor Ferenczi on trauma and vincularity, the author examines the operation of the mechanisms of dreaming in the processing of early traumatic situations and their clinical utilization. The difference is established between dreams of “repetition”, which lack dream imagery and contain a great amount of anguish, consisting of bodily sensations which may last on awakening, and the “secondary dream” with imagery, into which the first type can be transformed when the capacity of the psychic apparatus to process the traumatic situation is increased through therapeutic work. This “secondarization” of the repetitive dream has a traumatolytic effect, allowing the patient to reach psychoanalytically the mechanisms and mental states prevailing in the traumatic situation, through the mechanism of dream autorepresentation described by Silberer. In some cases, as illustrated in the clinical material, it is possible to anticipate the event of episodes of somatic disease before they become clinically evident.?The detailed analysis of dreams in patients with these characteristics is presented and discussed.     

Cumulative trauma and midlife well-being in American women who served in Vietnam: effects of combat exposure and postdeployment social support

Background and Objectives: Research increasingly demonstrates that trauma exposure can have cumulative effects, yet much remains to be learned about effects of cumulative trauma, particularly regarding longer term adjustment. One such trauma, combat exposure, is insufficiently understood, especially for women, who are increasingly engaged in professional combat activities. Design: The study comprised a cross-sectional survey assessing multiple aspects of current well-being in women approximately 25 years after their service in Vietnam during the Vietnam War. Methods: Participants were 1374 women (78% military and 22% nonmilitary; mean age = 59.7). This study investigated the relations between three separate categories of trauma exposure (childhood, adulthood, and combat) and well-being and examined whether perceived social support at return from Vietnam moderated the association between combat exposure and well-being. Results: While both childhood and adulthood trauma exposure related to midlife well-being, combat exposure still uniquely predicted outcomes. Further, postdeployment perceived social support moderated the association of combat and well-being: recollected higher perceived social support at homecoming buffered participants from the links between combat exposure and well-being. Conclusions: These results may have important implications for interventions to reduce the impact of traumatic experiences, particularly in light of the increasing exposure of women to direct combat events.     

Predicting adolescent posttraumatic stress in the aftermath of war: Differential effects of coping strategies across trauma reminder,loss reminder,and family conflict domains

Background and Objectives: The vast majority of youth who lived through the Bosnian war were exposed to multiple traumatic events, including interpersonal violence, community destruction, and the loss of a loved one. This study examined factors that predict post-war psychological adjustment, specifically posttraumatic stress, in Bosnian adolescents. Design: Regression analyses evaluated theorized differential relations between three types of post-war stressors – exposure to trauma reminders, loss reminders, and intrafamilial conflict – specific coping strategies, and posttraumatic stress symptom dimensions. Methods: We examined 555 Bosnian adolescents, aged 15–19 years, to predict their long-term posttraumatic stress reactions in the aftermath of war. Results: Findings indicated that post-war exposure to trauma reminders, loss reminders, and family conflict, as well as engagement and disengagement coping strategies, predicted posttraumatic stress symptoms. Secondary control engagement coping responses to all three types of post-war stressors were inversely associated with posttraumatic stress symptoms, whereas primary control engagement coping responses to family conflict were inversely associated with hyperarousal symptoms. Disengagement responses to trauma reminders and family conflict were positively associated with re-experiencing symptoms. Conclusions: These findings shed light on ways in which trauma reminders, loss reminders, and family conflict may intersect with coping responses to influence adolescent postwar adjustment.     

Chinese students in Japan: The mediator and the moderator between their personality and mental health

To clarify the influence of personality traits on the psychological acculturation of Chinese international students in Japan, the present study used three structuring questions: (a) What personality trait makes the students vulnerable to psychological distress? (b) What mediates between personality and psychological distress? (c) What buffers personality from psychological distress? The study examined personality traits (Harm‐Avoidance, HA; and Self‐Directedness, SD; two dimensions of the Temperament and Character Inventory), acculturation attitudes (integration, assimilation, separation, and marginalization), and the mental health (General Health Questionnaire (GHQ)‐30) of 253 Chinese students in Japan (17–30 years of age) using self‐report questionnaires. The hypotheses are: For the Chinese international students in Japan, (a) the individuals with high HA or low SD are more vulnerable to psychological distress; (b) the acculturation strategy mediates between personality (HA/SD) and mental health (GHQ); (c) social support can moderate the effect of personality on acculturation adaptation. The results show that the Chinese international students in Japan had higher GHQ scores compared to normative standards, and marginalization (a less adaptive strategy) was their second most preferred acculturation strategy, next to integration. Individuals with high HA or low SD were more likely to have a marginalization attitude and suffer from more psychological distress. The mediation effect of marginalization and the moderation effect of social support in life (SSL) between HA/SD and GHQ were confirmed. Most of the hypotheses were supported by the results. Explanations of these findings and their implication for acculturation adaptation are discussed.     

The impact of verbal and physical abuse on distress,mental health,and intentions to quit in sports officials

Sports officials (e.g., referees, umpires, judges) can experience distress from a multitude of sources, including episodes of verbal and physical abuse from spectators, coaches, and athletes. Little is known about the impact of this abuse on mental health (MH) outcomes and intentions to quit, however. As such, the primary aims of this study were to survey the prevalence and frequency of abuse in sports officials and to examine relationships between abuse, distress, and subsequent MH and intentions to quit outcomes. Survey data were collected from 438 Gaelic Games match officials. Of these, 94.29% and 23.06% had experienced verbal and physical abuse respectively during their career. Verbal abuse was mostly experienced a couple of times a season (reported by 43.83% of officials) or every couple of games (31.48%), whereas physical abuse was predominantly experienced once or twice in a career (85.15%). Structural equation modelling was used to assess three alternative models that proposed the relationship between experiences of abuse, and MH and intentions to quit outcomes to be either 1) direct, 2) indirect, fully mediated by distress, or 3) both direct and indirect, partially mediated by distress. For verbal abuse, only the direct and indirect effects model achieved acceptable fit and significantly explained variance in mental wellbeing (9.4%), anxiety (15.2%), depression (15.6%), and intentions to quit (19.1%). For physical abuse, though higher distress was associated with poorer MH and greater intentions to quit, none of the models fully explained the relationships between all variables. These findings demonstrate, for the first time, relationships between abuse, subsequent distress, and MH outcomes. We highlight the urgent need to develop evidence-based psychological interventions to tackle abuse, manage conflict, and support the MH needs of sports officials.