A Cultural Adaptation of Dialectical Behavior Therapy in Nepal

Growing evidence exists on the potential for adapting evidence-based interventions for low- and-middle-income countries (LMIC). One opportunity that has received limited attention is the adaptation of psychotherapies developed in high-income countries (HIC) based on principles from LMIC cultural groups. Dialectical behavior therapy (DBT) is one such treatment with significant potential for acceptability in South Asian settings with high suicide rates. We describe a tri-phasic approach to adapt DBT in Nepal that consists of qualitative interviews with major Nepali mental health stakeholders (Study 1), an adaptation workshop with 15 Nepali counselors (Study 2), and a small-scale treatment pilot with eligible clients in one rural district (Study 3). Due to low literacy levels, distinct conceptualizations of mind and body, and program adherence barriers, numerous adaptations were required. DBT concepts attributable to Asian belief systems were least comprehensible to clients. However, the 82% program completion rate suggests utility of a structured, skills-based treatment. This adaptation process informs future research regarding the effectiveness of culturally adapted DBT in South Asia.     

Test of the plausibility of adolescent substance use playing a causal role in developing adulthood antisocial behavior

DSM-IV antisocial personality disorder diagnosis requires that conduct disorder be exhibited before age 15. However, recent studies have reported on men and women without conduct disorder before age 15 but qualified for the adulthood antisocial personality criterion (AAB). This general-population, retrospective study investigated the plausibility of causal relationships between adolescent drug and alcohol misuse (ADAM) and AAB among subgroups who reported childhood-onset conduct problems (CP), adolescent-onset CP, or no more than one conduct problem. Data from the Epidemiological Catchment Area Study (N = 8,724) suggested that persons with childhood-onset CP are at much greater risk for AAB than persons with adolescent-onset CP. Nevertheless, large proportions of men and women with AAB had adolescent-onset CP or no CP. Regardless of CP history, being drunk by age 18 or having a drug use-related symptom before age 18 increased AAB risk, even after controlling for having a substance use-related disorder in adulthood. Mechanisms that potentially explain these associations are discussed.     

Sociotropy,autonomy, and personality disorder criteria in psychiatric patients

Sociotropy and autonomy (Beck, 1983) are sets of beliefs, concerns, and behavioral tendencies that are proposed to create vulnerability to depression and other psychopathology and to influence its manifestation and treatment response. Other theoretical frameworks (Blatt, 1974) have made similar suggestions. We investigated the differential relations of sociotropy and autonomy to dimensional scores for each DSM-III-R personality disorder (PD) in a sample of 188 psychiatric patients, controlling for the other set of characteristics and for the other PDs. Histrionic and dependent PD traits were related specifically to sociotropy. Paranoid, schizoid, schizotypal, and passive-aggressive PD traits were related specifically to autonomy. Borderline, narcissistic, avoidant, and self-defeating PD traits were related significantly and about equally to both sociotropy and autonomy. Obsessive-compulsive PD traits were not related consistently to either. Results were mostly as predicted and suggest that sociotropy and autonomy may be useful constructs for understanding and treating PDs.     

Overtraining and the complexities of coaches’ decision-making: managing elite athletes on the training cusp

In many elite sport performance contexts, overtraining is a critical issue for coaches to understand, recognise and respond to. While the indicators and effects of overtraining have attracted considerable research interest, there are no diagnostic tests that reliably predict impending overtraining. This study explores the practices and beliefs of three highly successful professional elite rowing coaches as they predict and manage the risk of athlete overtraining during crucial periods of intensive training. These coaches took part in a series of semi-structured interviews that explored their practices, philosophies and experiences. The research draws on sociological perspectives pertinent to coaching pedagogy and, more specifically, the tenets of naturalistic decision-making in exploring how the coaches define and make decisions about overtraining. In doing so it recognizes that coaching involves decision-making in complex and demanding situations. The coaches were found to monitor the fatigue of their rowers through observation, communication and measures of training pace. In general, the intuitions and cues that were used by coaches had little in common with overtraining markers or indicators that are promoted in the sport science literature. Coaches’ decision-making was based largely on subjective information and processes that were influenced by a range of stressors unique to their positions. We contend that the research provides an important new perspective on coaches’ definitions and management of overtraining and enables management of overtraining to be better understood as a key element of coaching pedagogy in elite performance settings. In this article we argue successful coaches have unique insights into this topical area and this is worthy of future exploration.     

Sociomoral reasoning,perceptions of parenting and self‐reported delinquency in adolescents

This study considers the relationships between perceived parenting, sociomoral reasoning, and self‐reported delinquency in a sample of high school adolescents. Correlational analysis revealed that moral reasoning was associated with a consistent disciplinary style. Self‐reported delinquency was positively related to a number of the parenting variables but negatively correlated with moral reasoning. Separate analysis for males and females showed similar patterns for self‐reported delinquency, with the exception that moral reasoning was negatively correlated with attachment and supervision among females. The most significant predictors of delinquency scores were parenting variables, with moral reasoning also playing a role for males. A factor analysis of the perceived parenting measure revealed two factors. The first factor reflected a warm, inductive and involved style of parenting with the second reflecting a parenting style characterized by physical punishment. Self‐reported delinquency was negatively significantly associated with Factor 1, and positively related to Factor 2. There were also differences in the self‐reported delinquency scores of the top and bottom quartiles of Factor 1 scores. These support the conclusion that a parental style that is perceived to be warm, involved and inductive is associated with lower levels of delinquency in adolescence. Copyright © 2001 John Wiley & Sons, Ltd.     

Social competence and sociomoral reasoning in young offenders

This study considers the relationship between social competence, sociomoral reasoning, and self‐reported delinquency in a sample of convicted young offenders. Correlations across these factors showed that social competence was significantly related to delinquency. This finding was corroborated by multiple regression, which showed that social competence was the most significant predictor of self‐reported delinquency. Copyright © 1999 John Wiley & Sons, Ltd.     

Islamophobia in Contemporary Britain: The Evidence of the Opinion Polls, 1988–2006

British attitudes towards Islam and Muslims are examined on the basis of 104 public opinion polls conducted between 1988 and 2006, 90 of them since 2001. Many of these surveys were undertaken at national crisis points of one sort or another for which Islam and Muslims could not avoid being seen as causal factors. Nine high-level conclusions are drawn from this evidence. There has been increasing Islamophobia, not least since 2001. A stereotypical picture of British Muslims in the eyes of the majority population has emerged, Muslims being seen as slow to integrate into mainstream society, feeling only a qualified sense of patriotism, and prone to espouse anti-Western values that lead many to condone so-called Islamic terrorism. To an extent, these stereotypes reflect the reality of Muslim views, as displayed in 29 polls conducted among the British Muslim community, mainly since 2001.     

Personality for free: Psychometric properties of a public domain Australian measure of the five‐factor model

Fifty items from Goldberg's International Personality Item Pool were compiled to form a public‐domain measure of personality, the Australian Personality Inventory (API). Data from a random community sample (N = 7615) and a university‐based sample (N = 271) were used to explore psychometric properties of this 50‐item measure of the five‐factor model of personality (FFM). In both samples, internal reliabilities were adequate. In the university‐based sample an appropriate pattern of convergent and divergent relationship was found between scale scores and domain scores from the NEO Five‐Factor Inventory. After adjusting for an apparent response set (mean response across items), exploratory factor analyses clearly retrieved the FFM in both samples. It is provisionally concluded that raw scale scores from the API provide reliable estimates of the FFM, but adjustment for mean response across the 50 items might clarify the five‐factor structure, especially in less educated samples.