Transcultural Psychiatry最新文献

Recent challenges to scientific authority in relation to the COVID pandemic, climate change, and the proliferation of conspiracy theories raise questions about the nature of knowledge and conviction. This article considers problems of social epistemology that are central to current predicaments about popular or public knowledge and the status of science. From the perspective of social epistemology, knowing and believing are not simply individual cognitive processes but based on participation in social systems, networks, and niches. As such, knowledge and conviction can be understood in terms of the dynamics of epistemic communities, which create specific forms of authority, norms, and practices that include styles of reasoning, habits of thought and modes of legitimation. Efforts to understand the dynamics of delusion and pathological conviction have something useful to teach us about our vulnerability as knowers and believers. However, this individual psychological account needs to be supplemented with a broader social view of the politics of knowledge that can inform efforts to create a healthy information ecology and strengthen the civil institutions that allow us to ground our action in well-informed picture of the world oriented toward mutual recognition, respect, diversity, and coexistence.

In many contemporary societies, misinformation, epistemic arrogance, and intergroup conflict pose serious threats to social cohesion and well-being. Wisdom may offer a potential antidote to these problems, with a recently identified Common Wisdom Model (CWM) suggesting that wisdom involves epistemic virtues such as intellectual humility, openness to change, and perspective-taking. However, it is unclear whether these virtues are central for folk concepts of wisdom in non-Western contexts. We explored this question by conducting focus group discussions with 174 participants from the Philippines and Sri Lanka, two countries facing socio-political and economic challenges. We found that epistemic themes were common in both countries, but more so when participants were asked to define wisdom in general terms rather than to describe how it is acquired or expressed in daily lives. Moreover, epistemic themes were more prevalent among Filipino than Sri Lankan participants, especially when the questions posed were abstract rather than concrete. We discuss how these findings relate to the CWM and the socio-cultural contexts of the two countries, and suggest that a question format should be considered in cross-cultural research on wisdom.

According to a naturalist conception of what counts as a disorder, conspiracy beliefs are pathological beliefs if they are the outcome of a cognitive dysfunction. In this article, I take issue with the view that it is pathological to believe a conspiracy theory. After reviewing several approaches to the aetiology of conspiracy beliefs, I find that no approach compels us to view conspiracy beliefs as the outcome of a dysfunction: a speaker's conspiracy beliefs can appear as implausible and unshakeable to an interpreter, but in a naturalist framework it is not pathological for the speaker to adopt and maintain such beliefs.

This article aims to show how incorrect ideas about COVID-19 were promoted by physicians in Brazil, contributing to a catastrophic response at the cost of hundreds of thousands of lives, and to examine the implications of this episode for the social studies of science, technology and medicine. The literature on the relationship between science and society takes two broad approaches, which are sometimes at odds with each other: (i) there is a traditional critique of science that points to unsupported claims of certainty and thus undue interference in general human affairs; (ii) there are many examples of attempts to undermine reasonable scientific claims, when they clash with economic and/or political interests of certain groups. Navigating those extremes is particularly critical in situations in which accurate knowledge is necessary for intervening in people's lives, as is the case in health-related issues. Determining who has actual epistemic expertise is a key factor in solving this conundrum. This became painfully clear during the unfolding of the COVID-19 pandemic, which highlighted the uncertainties of science in guiding decisions being made in real time, and provided opportunities for many forms of disinformation and conspiracy theories that hampered public health measures and promoted useless or even dangerous "treatments". This article discusses an instructive example of such developments in the chaotic response to the pandemic challenge in Brazil, which saw, among other unfortunate situations, physicians aligned with the denialist federal government advocating for unproven - or proven as ineffective - treatments and disseminating unfounded doubts about vaccines. Presumed expertise on the basis of professional training clearly did not translate into actual expertise in the necessary domains to ascertain the validity of such claims and scientific advice was overridden by ideology.

This essay introduces a thematic issue of Transcultural Psychiatry presenting selected papers from the 2022 McGill Advanced Study Institute in Cultural Psychiatry on "The Fragility of Truth: Social Epistemology in a Time of Polarization and Pandemic." The COVID-19 pandemic, political polarization, and the climate crisis have revealed that large segments of the population do not trust the best available knowledge and expertise in making vital decisions regarding their health, the governance of society, and the fate of the planet. What guides information-seeking, trust in authority, and decision-making in each of these domains? Articles in this issue include case studies of the dynamics of misinformation and disinformation; the adaptive functions and pathologies of belief, paranoia, and conspiracy theories; and strategies to foster and maintain diverse knowledge ecologies. Efforts to understand the psychological dynamics of pathological conviction have something useful to teach us about our vulnerability as knowers and believers. However, this individual psychological account needs to be supplemented with a broader social view of the politics of knowledge and epistemic authority that can inform efforts to create healthy information ecologies and strengthen the civic institutions and practices needed to provide well-informed pictures of the world as a basis for deliberative democracy, pluralism, and co-existence.

Polarization and turf-wars have characterized the COVID-19 response in the United States. While COVID-19 narratives can be binary and divisive, how people cared for each other throughout the first year of the pandemic is more nuanced. This article describes how and why constructs of fear, individualism, wellbeing, and personal risk-taking became imbued in behaviors that thwarted the risk of the collective. This work is based on informal conversations, public forums, and 86 in-depth interviews during the 2020 summer in a small tourist town in northwest Iowa. Some believed engaging in public health prevention was not their responsibility and instead privileged their personal enjoyment, finances, or mental health over others, de-emphasizing personal risk and stating God will protect them. Others were deeply committed to public health prevention, by staying home, masking, and social distancing. In both cases, people used shame to promote their views (e.g., shame on you for masking/unmasking!) as well as fear (e.g., I do/don't fear coronavirus because I am virtuous). However, most engaged in logics of care, navigating what public health precautions to follow to protect themselves and those they loved most. Yet, such decisions were navigated through a culture of individualism and ideals of personal responsibility that cultivated a mistrust in public health. Understanding how and why such individualism took hold in American publics is a crucial inflection point for policy-making as well as cultural interpretation of why and how people construct risk and responsibility.

The Liberian civil wars led to widespread destruction and devastation for its individuals, communities, and economy. However, individuals' subjective trauma experiences and long-term psychological impact remain relatively understudied. This study aims to explore context-specific traumatic events and examine how risk and protective factors combine with traumas to influence trajectories of suffering and recovery over time. We conducted 43 semi-structured interviews with Liberian adults who were present during the Liberian civil wars, and we used line-by-line open coding, thematic analysis, and axial coding to analyze and contextualize the data. Eight key trauma themes emerged: Abuse (emotional, physical, and sexual), Captivity, Combat, Killings, Physical Illness, Resource Loss, Family Separation, and War Environment. The risk and protective factors that were reported as salient were: Age, Biological Sex, Socioeconomic Status, and Community Support. Further, key patterns emerged across interviews that indicated greater risk for long-term suffering: 1) exposure to multiple traumatic events, 2) certain types of traumatic events (like killing of a close family member), and 3) the combination of specific traumatic events and risk and protective factors (like older women witnessing the killing of their children). This study provides culturally relevant information on trauma, suffering, and resilience in post-conflict Liberia, with the aim of guiding the development of screening tools and targeted psychological interventions that improve well-being over time.

Community reaction to refugees and asylum-seekers is often gauged by attitude surveys that are not designed to overcome built-in bias. Questionnaires that do not account for context and background consequently yield results that misrepresent community attitudes and offer predictably negative responses to immigrant groups. Such surveys can alter public perception, fuel anti-refugee sentiment, and affect policy simply because of how they are constructed. This model survey among humanitarian aid-workers from nine Greek non-governmental organizations uses specific techniques designed to overcome these challenges by applying sample familiarity, non-inflammatory hypothesis-testing, educational question stems, intentional ordering of questions, and direct questioning rather than surrogate measures like statistical approximation. Respondents working in the refugee crisis in Greece demonstrate how empathy, education, and exposure to refugees serve to overcome the harmful stereotypes of outsiders as contributors to crime, terror, and social burden.

Acceptance and Commitment Therapy (ACT) is an empirically supported psychotherapy that offers promise for the mental health of minoritised ethnic populations. Given the diversity of those presenting to inner-city services and barriers to accessing appropriate mental healthcare, we sought to develop a culturally syntonic ACT intervention for UK Vietnamese refugee communities in a practice-based partnership project between a National Health Service and local third-sector service in East London. The aim was to explore the feasibility, acceptability and impact of the adapted intervention to inform culturally inclusive clinical practice and future research. We outline key aspects of Vietnamese belief systems and culture, and consider how these might influence the optimisation of group-based ACT. We then present a mixed-method evaluation of the seven-session adapted ACT group for 11 participants (9 male and 5 female, aged between 44 and 73 years). Individual-level change analyses indicated clinically significant improvements in psychological flexibility for the minority of participants and a mixed pattern for impact on well-being. A thematic analysis and descriptive approach examined acceptability, feasibility and narratives of impact. Participants reported positive feedback on group experience, relevance and usefulness, and emergent themes indicate that the group facilitated key acceptance, commitment and behaviour-change processes, promoted social connections and increased engagement in meaningful life activities in relation to new perspectives and values-based action. Limitations are outlined, but overall, findings suggest preliminary support for the potential beneficial effect of the adapted ACT group as a feasible, culturally acceptable therapeutic approach for UK Vietnamese communities that is worthy of further investigation.