Anger and disgust shape judgments of social sanctions across cultures, especially in high individual autonomy societies.

When someone violates a social norm, others may think that some sanction would be appropriate. We examine how the experience of emotions like anger and disgust relate to the judged appropriateness of sanctions, in a pre-registered analysis of data from a large-scale study in 56 societies. Across the world, we find that individuals who experience anger and disgust over a norm violation are more likely to endorse confrontation, ostracism and, to a smaller extent, gossip. Moreover, we find that the experience of anger is consistently the strongest predictor of judgments of confrontation, compared to other emotions. Although the link between state-based emotions and judgments may seem universal, its strength varies across countries. Aligned with theoretical predictions, this link is stronger in societies, and among individuals, that place higher value on individual autonomy. Thus, autonomy values may increase the role that emotions play in guiding judgments of social sanctions.

Changes in social norms during the early stages of the COVID-19 pandemic across 43 countries.

The emergence of COVID-19 dramatically changed social behavior across societies and contexts. Here we study whether social norms also changed. Specifically, we study this question for cultural tightness (the degree to which societies generally have strong norms), specific social norms (e.g. stealing, hand washing), and norms about enforcement, using survey data from 30,431 respondents in 43 countries recorded before and in the early stages following the emergence of COVID-19. Using variation in disease intensity, we shed light on the mechanisms predicting changes in social norm measures. We find evidence that, after the emergence of the COVID-19 pandemic, hand washing norms increased while tightness and punishing frequency slightly decreased but observe no evidence for a robust change in most other norms. Thus, at least in the short term, our findings suggest that cultures are largely stable to pandemic threats except in those norms, hand washing in this case, that are perceived to be directly relevant to dealing with the collective threat.

Perceptions of the appropriate response to norm violation in 57 societies.

Norm enforcement may be important for resolving conflicts and promoting cooperation. However, little is known about how preferred responses to norm violations vary across cultures and across domains. In a preregistered study of 57 countries (using convenience samples of 22,863 students and non-students), we measured perceptions of the appropriateness of various responses to a violation of a cooperative norm and to atypical social behaviors. Our findings highlight both cultural universals and cultural variation. We find a universal negative relation between appropriateness ratings of norm violations and appropriateness ratings of responses in the form of confrontation, social ostracism and gossip. Moreover, we find the country variation in the appropriateness of sanctions to be consistent across different norm violations but not across different sanctions. Specifically, in those countries where use of physical confrontation and social ostracism is rated as less appropriate, gossip is rated as more appropriate.

Cross-cultural adaptation of the Type D Personality Scale for use with patients diagnosed with Ischemic Heart Disease in Sri Lanka.

INTRODUCTION: Ischemic Heart Disease (IHD), a major cardiovascular disease globally, has become the primary cause of death in Sri Lanka. Negative affectivity (NA) and social inhibition (SI) are two personality traits which increase the risk of IHD. The Type D Scale (DS-14) evaluates a person's general level of distress on NA and SI. However, DS-14 has not been translated and validated into Sinhala in Sri Lanka. OBJECTIVES: The study aimed to cross-culturally adapt and validate the DS-14 for use with Sinhala speaking patients diagnosed with IHD. METHODS: Translation, back translation and pre-test were conducted before a two-rounds of a Delphi process which assessed content and consensual validity of the instrument. The validated questionnaires were administered to 140 patients diagnosed with IHD at a Base Hospital. Factor structure was confirmed through Exploratory Factor Analysis (EFA) and Confirmatory Factor Analysis (CFA) and reliability, by internal consistency with Cronbach's alpha. RESULTS: The questionnaire was administered among 140 participants (85 females), aged 18-60 years. The DS-14 Sinhala version showed good content and consensual validity. Factor analysis proved two factors compatible with the original instrument, which explained the variance of 62.9%. CFA confirmed the two-factor model. The reliability analysis indicated Cronbach's alpha for NA and SI as 0.93 and 0.88, respectively. CONCLUSION: The cross-culturally adapted DS-14 Sinhala version indicated the same psychometric properties as the original instrument, in the local context with IHD patients. It can be confidently applied in the investigation of Type D personality in IHD prevention and treatment, as well as in research.

Disciplining in Sri Lankan Schools: A Cross-Sectional Study.

An integral part of a teacher's job is to correct misbehavior of students. There is scarcity of information on disciplinary methods used by teachers in schools in Sri Lanka. As a part of a larger research, this study was undertaken to fill this gap. A culturally validated questionnaire was used to assess the various disciplinary methods used by 459 teachers, on 948 students, in six districts in Sri Lanka. National, provincial, special education, and private schools were included in this study. The study revealed that teachers used aversive disciplinary methods such as corporal punishment and psychological aggression. During the past term, 80.4% of students reported experiencing at least one strategy of corporal punishment and 72.5% reported experiencing psychological aggression. It was alarming to note that 53% of students reported experiencing at least one strategy of physical abuse in the schools in Sri Lanka. In all, 79.3% of students reported experiencing at least one strategy of positive discipline. Although teachers did use positive discipline, it was lesser than the use of aversive disciplinary methods. Hence, the use of force as a tool of discipline on young people in schools in Sri Lanka is widespread. The findings of this study should raise grave concern and ring alarm bells among authorities in Sri Lanka. Therefore, several recommendations to rectify this situation are also presented herein.

Functional gastrointestinal diseases and psychological maladjustment, personality traits and quality of life.

BACKGROUND: Chronic abdominal pain is a common worldwide problem and known to be associated with psychological problems. This study evaluated the association between abdominal pain-predominant functional gastrointestinal disorders (AP-FGIDs), psychological maladjustment and personality traits in adolescents. METHODS: Adolescents aged 13-18 years were recruited from 5 randomly selected schools in Ampara district of Sri Lanka. AP-FGIDs were diagnosed using Rome III criteria. Translated and validated Rome III questionnaire (Child report form), personality questionnaire (PAQ) and PedsQL (Pediatric Quality of Life) inventory were used in data collection. Written consent was obtained from a parent and assent was obtained from every child recruited. The questionnaire was distributed in an examination setting to ensure confidentiality and privacy. Research assistants were present during data collection to assist on any necessary clarifications. RESULTS: A total of 1697 subjects were recruited [males 779 (45.9%), mean age 15.1 years, SD 1.6 years]. AP-FGIDs were present in 202 (11.9%). Those with AP-FGIDs had significantly higher mean scores for all personality traits (hostility and aggression, negative self-esteem, emotional unresponsiveness, emotional instability and negative world view), except dependency. Affected children had lower scores for all 4 domains of HRQoL (physical, emotional, social and school functioning), compared to controls (p < 0.05). When the cut off value for Sri Lankan children (89) was used, 66.3% with AP-FGIDs and 48.2% controls had PAQ scores within that of psychological maladjustment (p < 0.001). When the international normative value of 105 was used, these percentages were 27.2% and 14.2% respectively (p < 0.0001). The scores obtained for PAQ negatively correlated with scores obtained for HRQoL (r = - 0.52, p < 0.0001). One hundred and seventeen adolescents with AP-FGIDs (57.9%) had sought healthcare for their symptoms. Healthcare consulters had higher PAQ and lower HRQoL scores (p < 0.05). CONCLUSIONS: Adolescents with AP-FGIDs have more psychological maladjustment and abnormal personality traits than healthy controls. Affected adolescents with higher psychological maladjustments have lower HRQoL. Greater psychological maladjustment and lower HRQoL are associated with healthcare seeking behaviour in adolescents with AP-FGIDs.

Psychological impact on parents of children with congenital adrenal hyperplasia: a study from Sri Lanka.

INTRODUCTION: Congenital adrenal hyperplasia (CAH) is a group of autosomal recessively inherited disorders with significant morbidity. The long-term implications result in immense psychological stress to the parents. This study assessing the psychological impact on the parents is a first in Sri Lanka and one of the few worldwide. OBJECTIVE: Document the presence of depressive symptoms in parents of children with CAH. DESIGN: Study participants were 37 parents of children diagnosed with CAH who were attending an endocrinology clinic of the largest children's hospital in Sri Lanka. Centre for Epidemiological Studies-Depression scale (CES-D), a psychometrically sound scale for assessing depressive symptomatology, was used. RESULTS: The study classified 59% of the parents as being affected, and the psychological impact on them did not reduce with time. CONCLUSION: Parents of children with CAH demonstrated symptoms of depression that did not abate with the passage of time.

Psychological interventions in dermatology.

The objective of this paper is to introduce and emphasize the importance of psychological interventions for those with dermatological conditions. In keeping with the current literature, the author envisages a two-tier approach in the provision of such psychological interventions. Firstly, most patients with dermatology conditions may not require psychological change. Instead, they could be approached with effective doctor-patient communication skills, within a context of empathy and positive regard. At the second tier, however, based on the clinical interview, some patients may require varying degrees of psychological change in order to better manage their illness. In such a context, a dermatologist with training in psychotherapy would be required. In the absence of such a person, the patient may be referred to a psychologist or another mental health professional trained in psychotherapy.

Clinical psychology in a medical setting in Sri Lanka.

It is my observation that Sri Lankan clinical psychologists, contrary to international standards, can, at times, be prevented from independent practice by psychiatric colleagues. This paper suggests reasons for the sometimes strained relations between clinical psychology and psychiatry and discusses the future of the profession in Sri Lanka. An important step would be the establishment of separate departments of clinical psychology in the health system, rather than psychologists being situated within departments of psychiatry.

The use of mindfulness practice in the treatment of a case of obsessive compulsive disorder in Sri Lanka.

For over 20 centuries, Buddhism has been the spiritual practice of the majority of Sri Lankans. Though Buddhist practices have been increasingly influencing psychotherapy in the West, the use of such practices in psychotherapy in Sri Lanka is not common. This paper attempts to bridge this gap by presenting a case study where Buddhist mindfulness practice was used successfully in the treatment of a case of obsessive compulsive disorder. This paper also presents an outline of the association between Buddhist mindfulness practice and mindfulness practices used in modern-day psychotherapy and discusses issues in the use of mindfulness practice in psychotherapy.

The use of Buddhist mindfulness meditation in psychotherapy: a case report from Sri Lanka.

Buddhist practices have been increasingly influencing psychotherapy. For over 20 centuries, Buddhism has been the religion of a majority of Sri Lankans. However, there is little documentation of the use of Buddhist practices in psychotherapy in Sri Lanka. This paper presents a case study in which Theravadan Buddhist mindfulness meditation and cognitive therapy practices were used in the treatment of a client with depressive disorder. The paper also summarizes the influence of Buddhist concepts and mindfulness meditation on psychotherapy and illustrate how Buddhist doctrine and practices can be considered a psychotherapeutic method.

Outcomes of parental use of psychological aggression on children: a structural model from Sri Lanka.

The objective of this study was to explore the existence and, if so, the nature of the association between parental use of psychological aggression and psychological maladjustment in a 12-year-old Sri Lankan school population. A stratified random sampling technique was used to select 1,226 children from Colombo district schools. Three instruments, validated in the Sri Lankan context, were used to collect data on children's experience of psychological aggression, its psychological outcomes, and psychosocial correlates. The annual prevalence of psychological aggression reported by the study sample was 75%. A predictive model for psychological outcomes was examined. The experience of psychological aggression was shown to be moderately, but directly and significantly, associated with psychological maladjustment in children. This association was mediated by non-parentto-child violence-the child's knowledge of violence between the parents, experience of teacher violence, exposure to peer violence, and violence in the child's community. However, the child's report of a nurturant parent-child relationship did not impact on the association between psychological aggression and psychological maladjustment. The study also indicated that greater the child's experience of non-parent-to-child violence, the greater is his/her own level of hostility and aggression. These findings show that although many Sri Lankan parents use psychological aggression it has negative consequences for their children.

The relationship of posttraumatic growth to peritraumatic reactions and posttraumatic stress symptoms among Sri Lankan university students.

The relationships of posttraumatic growth to peritraumatic reactions and posttraumatic stress symptoms were examined in 93 Sri Lankan university students who had experienced a traumatic life event. Posttraumatic growth was associated with peritraumatic dissociation and posttraumatic stress symptoms, but was not associated with peritraumatic emotional distress. Results indicated a curvilinear relationship between peritraumatic dissociation and posttraumatic growth and between posttraumatic stress symptoms and posttraumatic growth. In a regression model predicting posttraumatic growth scores, each of the quadratic relationships of peritraumatic dissociation and posttraumatic stress symptoms to posttraumatic growth were statistically significant, and combined accounted for 22% of the variance. Results suggest that moderate levels of peritraumatic dissociation and symptoms are most associated with the greatest levels of growth.

Posttraumatic stress disorder among Sri Lankan University students as a consequence of their exposure to family violence.

The article presents the results of a study on the association between exposure to family violence (i.e., witnessing interparental violence and experiencing parental violence) during childhood and adolescence and adult posttraumatic stress disorder (PTSD). The study was conducted among a self-selected convenience sample of 476 students from Sri Lanka, using a self-administered questionnaire. The findings indicate that the more participants witnessed interparental violence and the more they experienced parental violence, the more they exhibited PTSD symptoms. Moreover, the findings reveal that participants' exposure to family violence explains a significant amount of the variance in their PTSD over and above the variance that can be attributed to their sociodemographic characteristics (age, gender, number of siblings, and family's socioeconomic status) and to their perceptions of the environment and functioning of their families. The limitations of the study and recommendations for future research are discussed.

Consequences of parental corporal punishment on 12-year old children in the Colombo district.

OBJECTIVE: To study the association between parental corporal punishment and psychological maladjustment in children. Potential mediating variables of this association were explored. The relationship between corporal punishment and physical abuse was also investigated. DESIGN, SETTING AND SAMPLE: The children (N = 1226, 12-year olds) were selected from government schools in the Colombo district, using a stratified random sampling technique. MEASUREMENTS: Self-administered instruments, adapted and validated to the Sri Lankan context were used. RESULTS: The experience of parental corporal punishment was shown to be moderately, but significantly, associated with psychological maladjustment in children. This association was enhanced by the child witnessing or experiencing non-parent-to-child violence (eg. domestic, community, teacher and peer violence). The extent of the child's support network, the nature of the parent-child relationship and the child's attitude to corporal punishment did not significantly alter the association between corporal punishment and psychological maladjustment. Corporal punishment was also moderately, but significantly, associated with child physical abuse. CONCLUSIONS: Parental corporal punishment is associated with psychological harm for children; this association is further enhanced by other forms of violence in a child's life.

Methods and sequelae of torture: a study in Sri Lanka.

A retrospective study was performed to document the physical and psychological methods of torture and their sequelae on 90 victims of torture who attended the Family Rehabilitation Centres in Vavuniya, Trincomalee and Anuradhapura, using a standard assessment format. The study showed that the methods of torture practised in Sri Lanka are similar to that of other countries. The methods are physical and psychological. Being a victim of a traumatic event would be physically and psychologically stressful.

Beliefs of Sri Lankan medical students about wife beating.

The article presents the results of a study on beliefs about wife beating conducted among 476 Sri Lankan medical students. Participants fill out a self-administered questionnaire, which examines six beliefs about wife beating. Most students tend to justify wife beating, to believe women benefit from wife beating, and to believe the wife bears more responsibility than the husband for violence against her. At the same time, most participants express willingness to help battered women. However, the vast majority oppose divorce as a solution to wife beating and are against punishing violent husbands. The results also reveal that a significant amount of the variance in each of the six beliefs are best explained by the students' patriarchal approach toward women and marriage and by their exposure to violence in their families of origin. The implications of the results for future research and theory development on beliefs about wife beating are discussed.

Adaptation and validation of the parent-child conflict tactics scale for use in Sri Lanka.

OBJECTIVE: The purpose of the study was to validate the Parent-Child Conflict Tactics Scale (CTSPC) in Sri Lanka, for use with 12-year old children. DESIGN: A Delphi Process determined the consensual and content validity of the CTSPC. Test-retest reliability and internal consistency were determined by a large and a small group administration. SETTING: Professionals from the social and behavioural sciences were the judges in the Delphi Process. Conveniently located schools in the Gampaha District were chosen for determining the test-retest reliability and internal consistency. MEASUREMENTS: This included original CTSPC and its Sinhala translation, a structured interview schedule and a focus group guide. RESULTS: The Sinhala version of the CTSPC showed adequate consensual and content validity. Its test-retest reliability and internal consistency were satisfactory. The instrument is best administered in small rather than in large groups of children. CONCLUSION: The Sinhala version of the CTSPC is appropriate to be used with 12-year old Sinhala speaking schoolchildren in Sri Lanka.

Child sexual abuse in Sri Lanka: the current state of affairs and recommendations for the future.

This article focuses on child sexual abuse in Sri Lanka. The background of child sexual abuse in the country and its current status are discussed. The role of the National Child Protection Authority, the primary governmental body concerned with child protection, is also explored. The article also brings to light various cultural dimensions that serve to call attention to the issue of sexual abuse of children in Sri Lanka. These are explored and illustrated with case vignettes from the author's clinical experience. Finally, the article elucidates the main issues and barriers in Sri Lanka that need to be surmounted in order to have an integrated service delivery in the care of the sexually abused child.