What constitutes globalised evidence? Cultural tensions and critical reflections of the evidence-based movement in New Zealand

The evidence-based movement (EBM) is grounded in a well-intentioned desire to ensure resources are invested in high quality initiatives that generate the intended impact. Nevertheless, recent critiques contest the appropriateness of translating an approach rooted in a medical model to socially complex initiatives. Globalised notions of evidence can also be damaging for programs operating in small, culturally diverse countries with limited resources. Given these polemic views, our aim was to examine local perceptions of the EBM in New Zealand, a small, vibrant, bicultural society with a mix of homegrown and imported programs. Using a snowball sampling approach, 79 professionals working in the education and social sectors completed an anonymous online survey that contained a series of closed and open-ended questions. The results show that although participants positively endorsed a variety of quality evidence markers, traditionally positivist methodological leanings received lower and more varied endorsements compared to more inclusive and pluralistic approaches. Many also expressed concern that the EBM emphasises a narrow and colonised view of evidence that does not align with Māori and Pacific worldviews, and undermines innovation. We discuss the implications as an avenue for advancing intervention and social programming research in an increasingly multicultural and globalised world.     

Diagnosis and Assessment of Depression and Suicidality Using the NIMH Diagnostic Interview Schedule for Children (DISC-2.3)

The Diagnostic Interview Schedule for Children (DISC-2.3) was studied in a sample of 265 adolescent inpatients to determine type and concurrent validity of depressive symptoms and depressive disorder diagnoses for different DISC-2.3 informants (parent, adolescent, both). The Children's Depression Rating Scale — Revised, Reynolds Adolescent Depression Scale (RADS), Suicide Ideation Questionnaire — Junior, Spectrum of Suicide Behavior Scale, and clinical consensus diagnoses were used to assess concurrent validity. Results indicated that (1) parents, compared to adolescents, reported a higher prevalence of all depressive symptoms with the exception of weight change; (2) DISC-2.3 depressive and suicidality symptoms were related positively to independent validating criteria for all informant conditions, suggesting good concurrent validity; (3) the DISC-2.3 both informant condition correctly identified the most depressive disorders; and (4) the parent, but not the adolescent, DISC-2.3 Informant condition contributed to the prediction of clinical consensus diagnoses of depression after taking into account RADS scores.     

Aphasia type and aging in Hindi-speaking stroke patients

In this study, the clinical profile of Hindi-speaking stroke patients with aphasia from northern India has been investigated. We examined the interactional effect between age and gender with aphasia type in 97 Hindi-speaking right-handed individuals, the majority of them with a confirmed diagnosis of a cerebrovascular accident. The subjects included in the study ranged from 3 weeks to two years post-onset with a diagnosis of a common classical aphasia (Broca's, Wernicke's, anomic, global, conduction, and transcortical) types involving both males and females. Also examined was the interaction between literacy and aphasia type since the subjects had varied exposures to education (total illiteracy to professional/university education). While the data reported here about Hindi-speaking aphasics are relatively in agreement with the age-aphasia type patterns discussed in western countries, nonetheless some differences were also observed. The mean age of Indian patients with aphasia was significantly lower. Also, in addition to some gender and literacy related differences, an outstanding difference was that many clinical symptoms that are known to co-occur with aphasia were not readily reported by subjects with stroke.     

Letting Go off the Control and Avoidance of Pain with Mindfulness and Acceptance

The cultural ethos of inevitability of pain and suffering in Geeta and Buddhism embark upon the therapeutic handling of pain in Psychotherapies also. The paper addresses the case of 28 year old male’s struggle with pain and how counseling is helping him with mindfulness and acceptance slowly taking over the control and avoidance as his copings with Acceptance and Commitment Therapy. The case study is illustrated with Hay’s concept of crucial fork in the road, that is, acceptance and commitment and control and avoidance circles.     

Prevalence and Nature of Spiritual Distress Among Palliative Care Patients in India

In palliative care research, little attention has been paid to the empirical study of spirituality in patients in non-Western countries. This study describes the prevalence and nature of spiritual distress among Indian palliative care patients. Data from 300 adult cancer patients who had completed a questionnaire with 36 spirituality items were analyzed. Spirituality was shaped by the Indian religious and economic context. A latent class analysis resulted in three clusters: trustful patients (46.4 %), spiritually distressed patients (17.4 %), and patients clinging to divine support (36.2 %). After regression, the clusters were found to be associated with pain scores (p < .001), gender (p = .034), and educational level (p < .006). More than half of the patients would benefit from spiritual counselling. More research and education on spirituality in Indian palliative care is urgently required.     

Generalized expectancies for negative mood regulation predict change in anxiety and depression among college students

Negative mood regulation (NMR) expectancies, or the beliefs held by individuals that, when faced with various manifestations of stress and negative affect, they can successfully cope with such mood states, have proven to be a most useful construct in the context of better understanding self-regulatory processes. In the present prospective study, we examined the predictive utility of NMR expectancies with respect to its ability to predict residual change in both depressive and anxiety symptoms over an 8-week timeframe in a sample of 322 college students. Initial correlational analyses revealed that, as anticipated, NMR expectancies were negatively correlated with depressive and anxiety symptomatology, as well as with maladaptive coping style. Conversely, NMR expectancies were positively associated with self-reported adaptive coping. A series of hierarchical regression analyses revealed that, even when controlling for age, sex, baseline levels of affective distress (depression or anxiety), and coping styles, NMR expectancies predicted change in both depressive and anxiety symptomatology. Implications of the findings pertinent to theory building and testing are discussed.     

Habituation to repeated stress: get used to it

Habituation, as described in the landmark paper by Thompson et al. [Thompson, R. F., & Spencer, W. A. (1966). Habituation: A model phenomenon for the study of neuronal substrates of behavior. Psychological Review, 73(1), 16–43], is a form of simple, nonassociative learning in which the magnitude of the response to a specific stimulus decreases with repeated exposure to that stimulus. A variety of neuronal and behavioral responses have been shown to be subject to habituation based on the criteria presented in that paper. It has been known for several decades that the magnitude of hypothalamic–pituitary–adrenal (HPA) activation occurring in response to a stressor declines with repeated exposure to that same stressor. For some time this decline has been referred to as “habituation” in the stress neurobiology literature. However, how this usage compares to the definition proposed by Thompson and Spencer has not been systematically addressed. For this special issue, we review the stress neurobiology literature and examine the support available for considering declines in HPA response to repeated stress to be response habituation in the sense defined by Thompson and Spencer. We conclude that habituation of HPA activity meets many, but not all, important criteria for response habituation, supporting the use of this term within the context of repeated stress. However, we also propose that response habituation can, at best, only partially explain the phenomenon of HPA habituation, which also involves well-known negative feedback mechanisms, activation of broad stress-related neural circuitry and potentially more complex associative learning mechanisms.     

Attitudes Towards Work and Family Roles and Their Implications for Career Growth of Women: A Report from India

This paper explored attitudes towards work and family roles of professional men and women in India. Ninety-two husband–wife pairs from salaried, upper middle class, dual-career families in India participated in the study. Propositions based on adult development theories of men and women, regarding reward value derived from and commitment made to occupational, parental, marital, and homemaker roles over the life cycle, were tested. Results indicated that there was no change with age, in attitudes towards occupational and homemaker roles. Instead, gender-based differences in attitudes towards these roles were observed. Attitudes towards the marital and parental role varied across the life cycle, although not in keeping with propositions based on the adult development theories of men and women. There was no reversal in attitudes towards work and family roles of men and women after midlife. Rather, some reversal in attitudes appeared to occur between the marital and parental role, over the life span of both men and women. Results are reviewed within the Indian cultural context and their implications for the career development of women are discussed.     

Stuttering acquired from subcortical pathologies and its alleviation from thalamic perturbation

Acquired stuttering subsequent to subcortical pathology of mesothalamus was observed in four neurosurgical subjects. The patients suffered from chronic pain, seizures, and somatosensory disorders. They also exhibited unpredictable and uncontrollable speech, spasmodic blocks which were devoid of accessory features, and adaptation effect. Therapeutic mesothalamic stimulation, used as a treatment of last resort to relieve the pain and associated symptoms, also had an ameliorating effect on the stuttering. Spontaneously occurring focal abnormal EEG discharges were anatomically delineated and used as a guide for therapeutic stimulation electrode placement. Attentuation of the abnormal discharges was followed by alleviation of symptoms. This investigation examines the clinical characteristics of stuttering in four neurosurgical patients and suggests an electropathologic basis for their mesothalamic-generated speech dysfluencies. The cooccurrence of pain, seizures, somatosensory disorders, and stuttering, and their concurrent amelioration, suggests that both chronic pain and stuttering may be implicated by similar or related reticular electropathologic generators, couched in overlapping reticular networks extending from the brain stem to the thalamus, and that the acquired stuttering may be recruited as one component of a larger syndrome complex.