L’évaluation psychologique en situation transculturelle : une révision de la littérature

Human migration provokes transcultural clinical encounters that may challenge the way clinicians see themselves and how they proceed in their usual practices. In the field of psychology, psychological assessment is an important tool to better understand the patients’ needs and to design psychological interventions. Considering that most diagnostic tests and manuals have been developed in the Western context, the application of these tools with other populations remains controversial. The present literature review aims to describe the state of current knowledge on psychological transcultural assessment. Specifically, we will address: (1) the use of psychological tests in transcultural contexts, (2) the development of the Cultural Formulation Interview (CFI, DSM-5) and (3) the clinical interview: language, therapeutic relationship and participation of interpreters. In the first section, we discuss the international norms for scales and tests translation and adaptation, as well as the cultural issues that may bias the test’ application and interpretation. In the second section, we describe the creation of the CFI, and its use in recent studies. The CFI is composed by four clusters: (1) cultural definition of a problem, (2) cultural perceptions of cause, context, and support, (3) cultural factors affecting self-coping and past help seeking, and (4) cultural factors affecting current help seeking. The revised studies indicated that the CFI has a positive impact on the cultural sensibilization of mental health professionals, also improving the relationship between the patients and professionals. The cultural formulation may also prevent misdiagnosis. Beyond the use of tests and structured interviews, the clinician also faces other challenges during a transcultural assessment. We discuss in the third section the transferential and countertransferential relationship in a transcultural situation. Several elements may influence this relationship, at an individual, institutional and societal level. The evaluation of these elements may allow the clinician to better understand results of the psychological assessment. We also describe the current guidelines for the use of interpreters during health consultations in France. In conclusion, several advances have been made in the field of transcultural psychological assessment, among other things the development of guides for good translation and cultural adaptation of tools, as well as the integration of cultural issues into the DSM. However, research and changes in clinical practice are still needed, as the evaluation of cultural biases in cognitive tests and the expansion of cultural competences training among clinicians.     

Evidence for the Syndrome of Nonverbal Learning Disabilities in Children with Brain Tumors

This study examined the predicted utility of the Nonverbal Learning Disabilities syndrome (NLD) (Rourke, 1995) for characterizing neurocognitive and psychosocial outcomes in 123 children with brain tumors. Children with brain tumors were found to be at high risk of having a specific academic deficit, particularly in arithmetic. Children with arithmetic deficit evidenced a higher rate of impairment on nonverbal tasks than on verbal tasks, whereas children with reading deficit evidenced a higher rate of impairment on verbal tasks than on nonverbal tasks. However, significant differences between children with arithmetic and reading deficits were not found for all of the component features of the NLD syndrome, and arithmetic deficit was not related to treatment with irradiation.     

Cultural and Religious Values: A Cross-Cultural Study In Austria,South Africa and Egypt

This article compares religious values found on the basis of the lexical approach in three cultures. Lists of human values in Austria (German), South Africa (Northern Sotho) and Egypt (Arabic) were compiled. These terms were rated by 456, 400 and 773 participants respectively as personal guiding motives in life. Factor analyses yielded orthogonal dimensions reflecting the specific values of each culture. In all three cases, a dimension pertaining to religious issues emerged. For Austria, a distinct dimension was found, which only comprised religious terms. In South Africa religious values were interrelated with mutual support, while in Egypt, religiosity was highly correlated with political concerns and Arabic nationalism. While only about 25% of the Austrian sample gave positive evaluations to religious values, most of the South African and Egyptian participants rated religiosity positively. Results suggest that religious values are ubiquitous and religious convictions are influenced by the ethical concepts in each culture.     

The Theory-Practice Gap in Cognitive-Behavior Therapy

This special series is devoted to understanding the theory-practice gap in cognitive-behavior therapy (CBT). Although CBT enjoys considerable empirical support, and is widely recognized as an efficacious approach to a diversity of psychiatric disorders and includes many different forms of treatment, it is unclear whether clinicians are familiar with the underlying theories of the treatments they are practicing. Moreover, it is unclear to what degree an understanding of the theory is necessary for effective practice. Gaining clarity on the role of understanding underlying theory and identifying potential disparities between theory and practice may have implications for the way graduate training programs are structured and current professionals approach continuing education. A brief exploration of these implications will be offered by introducing issues related to the scientist-practitioner model and dissemination of efficacious treatments, in addition to an outline of potential advantages and disadvantages of knowing underlying theory. This special series will then feature several major approaches to treatment wherein the role of theory and practice are discussed.     

The Theory-Practice Gap in Cognitive Behavioral Therapy: Reflections and a Modest Proposal to Bridge the Gap

This paper examines the issues related to the gap between theory and practice in the area of cognitive-behavioral therapy. The article begins with a review of the evidence for such a gap, and having demonstrated that the gap exists, provides a discussion of some of the factors that are likely important in its genesis and maintenance. The article then focuses on potential strategies to reduce the theory-practice gap that go beyond the common recommendation for both efficacy and effectiveness research. In particular, we provide recommendations for protocol planning and design, training and competency maintenance, dissemination research, and implementation and policy change. We conclude with the proposition that theory and research should not only inform practice, but that practice should have a reciprocal benefit on theory and research.     

The cultural mediation hypothesis: A critical examination

A fascinating hypothesis has been proposed by Woodley (2010, Intelligence, 38: 471–480) to explain why intelligence, in contemporary Western countries, appears to be positively associated with left wing political attitudes. According to the hypothesis, the current Western ‘norm’ is relatively left-wing values, the intelligent are better at norm-mapping and better at perceiving the benefits of conforming to the dominant set of values and this explains why they are more likely, in this context, to be relatively left wing. This article will critically examine this hypothesis. It will argue that the evidence for it is questionable and open to different interpretations, there is evidence that contradicts it, and it leaves key questions unanswered. The article will propose that a simpler explanation for the association is that intelligence is positively associated with openness-intellect, low time preference and agreeableness.     

In-Session Stuck Points and Pitfalls of Community Clinicians Learning CBT: Qualitative Investigation

Given the preponderance of evidence supporting the efficacy of cognitive behavior therapy (CBT), there has been an increased emphasis on dissemination to community mental health systems (CMH). Trainers from two large-scale dissemination initiatives (n = 27) were surveyed regarding the common pitfalls and difficulties encountered by CMH clinicians learning CBT. Common pitfalls were organized according to the items of the Cognitive Therapy Rating Scale (CTRS; Young & Beck, 1980) and reviewed. Guided discovery was reported to be the most challenging CBT competency to learn. Qualitative methods were used to construct a grounded theory; trainer responses indicated they viewed the practice of CBT as not only a set of discrete skills, but also a way of thinking. Efforts may be needed to provide support, assistance, and resources to these CMH clinicians as they continue to build CBT competency.     

Development,Acceptability, and Effectiveness of an Acceptance-Based Behavioral Stress/Anxiety Management Workshop for University Students

College is a critical time in which individuals experience transition and stress, and may experience subthreshold or clinical symptoms of anxiety and depression. In addition, educational contexts offer a unique opportunity to serve the needs of a diverse group of students who may experience additional stressors related to experiences with discrimination; acculturative stress; financial strain; and balancing family, work, and school demands. Therefore, college appears to be an ideal time for students to learn about evidence-based skills to use in response to anxiety and depression.However, there are multiple barriers that may make it less likely that evidence-based skills and services are available to or utilized by students, including lack of funding and services available on campus, as well as concerns about mental health stigma. This study examines the preliminary acceptability and effectiveness of an acceptance-based behavioral stress/anxiety management workshop for university students on a diverse urban campus. Results indicate that participants found the workshop to be acceptable and helpful. Mixed-effect regression models examining symptom and impairment measures at preworkshop, 1-week follow-up, and 4-week follow-up showed a significant effect for time on anxious arousal, general anxiety symptoms, and social anxiety, but no significant effect for time on impairment. Implications and future directions for mindfulness and acceptance-based approaches in educational contexts are discussed.     

Contextualizing rape: Reviewing sequelae and proposing a culturally inclusive ecological model of sexual assault recovery

Consistent evidence demonstrates that many women who encounter the trauma of rape experience a range of both acute reactions and chronic psychological sequelae. This article reviews both the short- and long-term psychological adjustment issues associated with rape. In addition, we propose a culturally inclusive ecological model of sexual assault recovery (CIEMSAR), which integrates and extends existing models to better examine the complex factors leading to differential postrape adjustment. Important components of the CIEMSAR are placing rape in the broader sociocultural context of the United States and explicated socioracial and ethnic factors influencing the recovery process. The five primary factors of CIEMSAR are outlined, including (a) macrosystem or sociocultural context factors; microsystem/individual factors such as (b) assault characteristics, (c) person variables, (d) coping responses; and mesosystems factors such as (e) social-support systems. Suggestions for future research are also provided.