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The chapter sees India as a stain on Churchill’s reputation. As a young officer, Churchill spent twenty-two months in India, representing his longest concentrated stay outside of Britain, but his prejudice against Anglo-Indians meant that he engaged only with the elites of British India and remained isolated. The Empire and its permanence became the bedrock of a deep-seated conviction just at the time of India’s nationalist upsurge for self-rule and independence. He condemned the Amritsar massacre but thereafter opposed all ideas for Indian political evolution. The fact that he held no responsibility for India affairs apart from May 1940 to July 1945 did not stop him speaking about the subcontinent. His campaign against the India Act of 1935 was conducted at enormous political cost to himself and left the leaders of the Indian independence movement embittered, contributing to Hindu–Muslim polarisation. During the Second World War Churchill manipulated Britain’s response to the Indian independence movement, titling policy in favour of Jinnah and the creation of Pakistan. His response to the Bengal Famine has to be framed in terms of race.
Federation was promoted as an ideal before and between the two world wars, in both colonial independence movements and internationalist thought. It also became a term for promoting reforms to imperial governance, referring sometimes to greater political and economic integration and at other times to devolution or self-rule. Writers around the world responded to these developments directly, in specific political and constitutional discussions, and through indirect engagement with federalism’s rhetorical, conceptual, historical, and affective structures. Modernists such as Gertrude Stein, W. H. Auden, Virginia Woolf, and William Faulkner exemplify the range of white metropolitan writers’ playful, earnest, and creative engagements with federal themes during the interwar period. Paradigmatic of a so-called ‘federal moment’ amidst global decolonisation movements during the post-war period, Salman Rushdie’s Midnight’s Children illustrates federalism’s contested status as both a legacy of colonial rule and a potential mechanism for imagining postcolonial futures.
Dyadic coping-based gratitude (DC-G) refers to the reaction of appreciation and thankfulness in response to received problem-focused and emotion-focused positive dyadic coping (DC) behaviors by the partner. The actor-partner interdependent mediation model was used to test the mediating role of DC-G between DC and relationship satisfaction in a purposive sample of 300 Pakistani married couples, which were treated as indistinguishable following the use of a test for distinguishability. Mediation analysis demonstrated that DC-G partially mediated the couples’ DC and relationship satisfaction implying that the association between DC and relationship satisfaction strengthened as the DC-G intervenes in the path model. Additionally, the actor-actor or partner-partner indirect effects were stronger compared to the cross-partner effect suggesting that husbands or wives’ DC more strongly predicted corresponding relationship satisfaction via DC-G compared to husbands-wives’ DC. Implications are discussed within collectivistic cultural orientation and Islamic religious obligations regarding marital relationships in Pakistani couples.
Bipolar disorder is a source of marked disability, morbidity and premature death. There is a paucity of research on personalised psychosocial interventions for bipolar disorder, especially in low-resource settings. A pilot randomised controlled trial (RCT) of a culturally adapted psychoeducation intervention for bipolar disorder (CaPE) in Pakistan reported higher patient satisfaction, enhanced medication adherence, knowledge and attitudes regarding bipolar disorder, and improvement in mood symptom scores and health-related quality of life measures compared with treatment as usual (TAU).
Aims
The current protocol describes a larger multicentre RCT to confirm the clinical and cost-effectiveness of CaPE in Pakistan. Trial registration: NCT05223959.
Method
A multicentre individual, parallel-arm RCT of CaPE in 300 Pakistani adults with bipolar disorder. Participants over the age of 18, with a diagnosis of bipolar I or II disorder who are currently euthymic, will be recruited from seven sites: Karachi, Lahore, Multan, Rawalpindi, Peshawar, Hyderabad and Quetta. Time to recurrence will be the primary outcome assessed using the Longitudinal Interval Follow-up Evaluation (LIFE). Secondary measures will include mood symptoms, quality of life and functioning, adherence to psychotropic medications, and knowledge and attitudes regarding bipolar disorder.
Results
This trial will assess the effectiveness of the CaPE intervention compared with TAU in reducing the time to recurrence for people with bipolar disorder currently in remission in Pakistan and determine the effect on clinical outcomes, quality of life and functioning.
Conclusions
A successful trial might lead to rapid implementation of CaPE in clinical practice, not only in Pakistan, but also in other low-resource settings, including those in high-income countries, to improve clinical outcomes, social and occupational functioning, and quality of life in South Asian and other minority group patients with bipolar disorder.
Under what conditions do democratic actors such as political parties engage in, or facilitate, violence? What determines the strategy of violence that a party employs and how do these strategies in turn regulate the overall levels of violence in society? And, importantly, what are the effects of such violence on the prospects for democratic transition and consolidation? This chapter poses the questions that form the basis of empirical inquiry in the book. It introduces the main argument, which centers on the subnational political landscape of state coercive capacity, the elasticity of a party’s support base, and party organizational capacity. The intersection of these variables determines whether a party will engage in violence directly through party cadres, outsource it to violence specialists, form alliances with elite violence specialists, or abstain altogether. I outline how examining these outcomes, and the process by which they come to be, addresses several fundamental questions at the core of the study of political violence and democracy. I provide the scope conditions of my argument and explore alternative explanations for party violence. Finally, I describe my empirical approach, which involved multiple original surveys, new datasets of historical material, and extensive qualitative fieldwork.
Chapter 3 provides an overview of the political climate in Pakistan, setting the stage for the empirical cases which follow. It provides brief but essential context on political representation, state capacity, and manifestations of violence in Pakistan. I explain in more detail the manner in which state institutions, including the police and military, interact with political parties and local strongmen to determine the cost and incentive structure parties encounter. I focus on two types of political landscapes in Pakistan, shared sovereignty and multiple competing sovereigns, and introduce the particular dynamics of political representation and violence in each. In doing so, I highlight the important role played by such structural factors as land and socioeconomic inequality, ethnic demographics, urban sprawl, and the availability of arms and ammunition. I then provide brief overviews of the four main political parties discussed in this book, with a focus on the parties’ organizational structures and how these structures came to be.
This chapter examines the advantages and the hazards of the current approach to environmental public interest litigation, including climate litigation, in Pakistan. It begins with a look at the history of environmental litigation in Pakistan. Building upon that, the chapter continues with an analysis of climate change litigation specifically and how it relates to broader judicial trends. The chapter concludes by underscoring the limitations of climate public interest litigation in Pakistan, despite some high-profile wins.
Intimate partner Violence (IPV) against women includes all actions that violate one’s sense of self, physical body and sense of trust and involves episodes of violence of physical, psychological (emotional), or sexual nature, perpetrated by a current or former intimate partner.
Objectives
We estimated the prevalence of and risk factors for intimate partner violence (IPV) in the Himalayan mountain villages of Gilgit Baltistan in Pakistan.
Methods
We employed a cross-sectional study to randomly select ever married women (n=789) aged 18-49, in Pakistan. We used an adapted World Health Organization screening instrument to assess women’s experience of IPV in the previous 12 months. We used an indigenous validated instrument assess self-reported symptoms of major depression according to the DSM IV. Multivariable logistic regression analysis was used to identify significant predictors of IPV using adjusted odds ratio (AOR) with 95% confidence intervals (CI).
Results
The overall prevalence of IPV was 22.8% (95% CI: 20.0-25.9). Women exposed to IPV were less likely to have husbands educated at a college or a higher (AOR: 0.40; 95%CI: 0.22-0.70), household income in the middle or the highest tertile (AOR: 0.44; 95%CI: 0.29-0.68), and were more likely to have poor or very poor relationship with their mother in law (AOR=2.85; 95% CI: 1.90-4.28), to have a poor quality of health (AOR= 2.74; 95% CI: 1.92-3.92) poor quality of life (AOR= 3.54; 95%CI: 1.90-6.58), and higher odds of experiencing depressive symptoms (AOR=1.97; 95%CI:1.39-2.77).
Conclusions
IPV is a substantial public health burden in Himalayan mountain villages and merits serious attention.
Chapter 7 presents the third of the three case studies: Killing the Individual Human Being via Drones. Here I look at targeted killings and the growing use of drones in this practice. The chapter offers a detailed discussion of the predominantly legal and ethical debate. In doing so, the chapter demonstrates the relevance of an analysis guided by insights from IR theory. But it also discusses legal questions concerning International Human Rights Law and International Humanitarian Law. The case study engages in detail with the general discourse on drone strikes and targeted killings and provides an in-depth analysis of specific strike types and drone strikes. The analysis demonstrates how the individual human being appears as an innocent civilian who should not be killed (if possible) or as a guilty terrorist who should be killed.
No statutory mental health services exist for justice-involved individuals in Pakistan. The lack of expertise in forensic psychiatry serves to deny individuals with mental illness the critical support needed for mental healthcare and adequate court dispositions with serious unintended consequences including capital punishment for those who could otherwise be deemed treatment and not punishment worthy. A landmark judgement by the Supreme Court of Pakistan in February 2021 criticized the lack of forensic psychiatry expertise in Pakistan and directing the development of forensic mental health services and forensic psychiatry training in Pakistan.
Objectives
The key objectives are: 1. Understanding the timeline of how justice invloved individuals are manged by psychiatric services 2. The importance of the Supreme Court of Pakistan Judgement in affecting change 3. Highlights on how Queen’s University will enhance forensic psychiatry in Pakistan
Methods
A literature review and personal networking facilitated the collection of important data in how justice invloved individuals are supported in Pakistan. The author has published and presented to Pakistani psychiatrists and the Pakistani judiciary on this topic. Queen’s University is aiming to implement a 3-year plan to develop an online curriculum and certificate course to help train the trainers.
Results
In the Pakistan’s most populous province, Punjab, prevalence rates for psychotic illnesses (3.7%), major depression (10%), and personality disorders (65%) among men with higher rates for psychotic disorders (4.0%) and major depression (12%) among women.
Conclusions
In conclusion there is a dire need to develop forensic psychiatry in Pakistan and other low/middle income countries.
Self‑harm is an ‘act of self‑poisoning or self‑injury carried out by a person, irrespective of their motivation’. A history of self-harm is linked with suicide risk. A study in Pakistan found self-harm to be more common in young people with unemployment and interpersonal difficulties as common triggers. Expanding liaison psychiatry services leads to an earlier assessment of patients with self-harm.
Objectives
To study the demographic and clinical variables of patients along with methods and precipitating factors of self-harm.
Methods
A retrospective chart review of patients presenting with self-harm seen as a part of liaison psychiatry from October 2018 to June 2021.
Results
A total of 168 cases were seen of which 10 were excluded due to incomplete data. Of 158 cases gender split was roughly in the middle, with 49.4% males (n=78) and 50.6% females (n=80). The mean age of patients was 27.59 with a range of 12-70, 40.5% belonged to the age group of 20-29 (n=64) (Figure 1).
77.8% (n=123) had a past psychiatric history. The most common being depressive disorder 31.6% (n=50) and borderline personality disorder 30.4% (n=48). 35.4% of patients reportedly had previous attempts of self-harm. The most common methods being the use of sharp objects, rat-pill poisoning, and corrosive intake (Figure 2).
Conflicts with family and relationship difficulties were reported to be the most common precipitating factors.
Conclusions
Self-harm is a challenging and frequent presentation. Patients may present with diverse characteristics and varying needs. Hence physicians must be prepared for timely liaison and prompt management.
Psychological assessment is deemed one of the most crucial parts of the science of psychology, particularly its clinical branch, and has helped enhance its credibility to a great extent. Although a considerable number of psychological assessment movements have originated in North America and Europe, limiting the developmental aspects of ongoing research on assessment trends and techniques to the aforementioned regions, and disregarding the role of other regions in the further development of this branch seems unjust and irrational. Moreover, the growing tendencies in adopting a reductionist approach in natural science and overlooking the importance of cultural aspects over the past decades have damaged the true nature of psychological assessment. The role played by culture and other contextual variables in psychological research has been duly emphasized, to such a degree that any clinical or psychological decision making without taking these factors into consideration is faced with skepticism. In this chapter, we will examine the historical trends in psychological assessment in Central Asia (Iran, Pakistan, Afghanistan, Tajikistan, Uzbekistan, Kazakhstan, Turkmenistan, and Kyrgyzstan) while discussing the scientific and research potential of its countries in expanding the field of psychological assessment.
This essay advocates “refugee political thought” as an autonomous category which needs to be centre-staged in global intellectual history. I concretise this by studying Bengali Hindu refugees who migrated from Muslim-majority eastern Bengal (after the Partition of British India in 1947 part of Pakistan, and after 1971, the sovereign state of Bangladesh) to the Hindu-majority Indian state of West Bengal, and occasionally their descendants as well. By studying the transnational horizons of Bengali refugees from the late 1940s to today, I posit them as part of modern global intellectual history. Bengali refugees and their descendants connected their experiences with those of refugees elsewhere in the world, seeing themselves, for example, as “new Jews.” Later, some of them aligned themselves with the Palestinian cause. Refugee politics became enmeshed with Cold War revolutionary currents. European, Soviet, and Chinese Marxist theory—and latent Lockean assumptions—propelled the everyday politics of refugee land occupation. Marxism, sometimes with Hegelian inflection, nourished the East Bengali-–origin founders of Subaltern Studies theory and Dalit (lower-caste) thought. Ultimately, this essay shows how Bengali refugees instrumentalised transnational thinking to produce new models of democratic political thought and practice in postcolonial India. I describe this as “refugee democracy.”
In this chapter, I explore the influence of the patchwork state in variation in electoral competition. The chapter begins with presenting the dominant framework in South Asian politics, that of clientelism, and argues that historical variations in the structure of patronage, due to patchwork forms of Authority within India, Pakistan, and Bangladesh shapes the nature and consequences of electoral competition. Variations in the capacity of public officials to determine the distribution of patronage might explain a puzzle in India and Pakistani politics, that of variation in the number of parties in serious contention at the constituency level. The chapter then presents data on the effective number of parties (ENP) by postcolonial governance categories in India and Pakistan, and explores Bangladesh’s exception to patchwork state dynamics. The chapter concludes with a discussion of the relationship among elections, violence, and the patchwork state.
This chapter explores the ways that postcolonial governments of India and Pakistan attempted to homogenize governance arrangements within their territories; this project was not entirely successful, but did lead to substantial revision of colonial categories. It begins with a discussion of the foreclosed possibility of Home Rule arrangements in which distinctions in governance practice might have persisted in practice after independence in a united India; the politics of Partition instead led to the formation of two sovereign states, but with significant variation in the power and authority of the state in each. It explores the particular politics in India and Pakistan that limited each country’s ability to undertake fundamental reform of the state and the homogenization of governance procedures, including differing perspectives among political leaders on how best to deliver security and development, and the persistence of bureaucratic structures. It also outlines the roots of a more even political geography in Bangladesh, an exception to the patchwork states of India and Pakistan. The chapter concludes with a discussion of how the colonial forms of governance translates into a postcolonial typology of governance arrangements, with distinctions in state capacity and state-society relations.
This chapter introduces the book. It begins with an examination of the many different types of violence in India, Pakistan, and Bangladesh, from insurgencies and terrorist attacks to violence within society; extant approaches to explaining violence and conflict cannot explain such variety within national borders. It introduces the patchwork states framework: the notion that the spatial politics of competition and conflict can be traced back to state-building under colonial rule, and postcolonial revisions to that rule. It then lays out the ways in which colonial administrators established different forms of governance arrangements across the Indian subcontinent as a response to greed, fear, and frugality. Postcolonial governments attempted to revise these arrangements, but with limited success, yielding differences in state capacity and state–society relations within India, Pakistan, and Bangladesh. The chapter then introduces the ways in which differences in governance leads to legible patterns of political violence at the local level – including the incidence of sovereignty-contesting and sovereignty-neutral violence –– as well as the broader politics of conflict and competition, impacting electoral and development outcomes. The chapter concludes by discussing some of the implications of the argument and outlining subsequent chapters.
In the first empirical chapter, I outline how different subnational governance arrangements, rooted in colonial state building and postcolonial revisions to state structures, shape the patterns of violence in Indian, Pakistani, and Bangladeshi districts. It begins weather discussion of the relationships between state authority and violence, and introduces the key typology of sovereignty-contesting violence (SCV) and sovereignty-neutral violence (SNV). It then surveys the disparate literatures on the various forms of political violence in South Asian countries, suggesting that this typology can provide a way of bridging the divides between these literatures. The chapter then lays out patterns and qualitative examples of these two different forms of violence in the three country. It concludes with a discussion of the limitations of the patchwork state framework in understanding rebellion in South Asia.