Epistemic Stance Research Articles

Mental health promotion research in co-creation: Lessons from a multisite study in six countries

Abstract Background Mounting public health threats associated with climate change, epidemiological and economic crises, digitalisation, rising migration, and population aging have uncovered at-risk groups’ increased vulnerability to mental ill health. Developing mental health promotion interventions tailored to their specific needs and expectations is essential to protect their wellbeing. However, researchers may find it challenging to identify and implement needed adaptations without engaging with end-users, and other stakeholders, to co-create tailor-made interventions. This study aimed to explore co-creators’ views about opportunities and constraints in participatory mental health promotion research. Methods Between September 2023 and July 2024, a qualitative study drawing on participant observation of bimonthly meetings and semi-structured interviews with six co-creation facilitators was conducted in the scope of Horizon Europe’s project ADVANCE. The multi-methods research approach to co-creation entailed desk reviews and online Delphi surveys co-developed with locally-established Society Advisory Groups, and scenario-based workshops held with stakeholders in the six partner countries: Denmark, Germany, Italy, Lithuania, Netherlands, Switzerland. Thematic analysis of the data was carried out. Results Research teams’ epistemic stances impact research planning, resource allocation, partnership nourishing and the unravelling of co-option risks during participatory research implementation. Research co-creation adds pressure onto research teams’ agenda, skillset and performance, but it also encourages power sharing, mutual learning and greater alignment of research design and implementation with end-users’ priorities and aspirations. Conclusions Research co-creation is a partnership-based and resource-intensive endeavour that can provide a valuable pathway to improve the relevance, acceptability and sustainability of public mental health promotion research. Key messages • Research co-creation demands planning, adequate resource allocation, flexibility and continuous investment to sustain academy-society partnerships. • Engaging stakeholders in knowledge co-creation can increase the relevance, acceptability and sustainability of public mental health promotion research.

When TCM debate meets Covid-19 discourse

Abstract The Covid-19 pandemic has pushed medical discourse to the forefront of everyday communication, but limited scholarly attention has been given to its intersection with social-mediated language use in the Chinese context. From a corpus-pragmatic view, we examined textual data collected from Zhihu, the most popular Chinese community question-answering site. Our analysis focused on the linguistic mechanism of evidential expression in social-mediated debates on Traditional Chinese medicine (TCM). Within the realm of medical scientific discussion, we identified a prevailing epistemic stance of doubt and uncertainty towards the efficacy of TCM, emphasising its socio-political significance. We also demonstrated how the ‘source of knowledge’ value and the ‘speaker commitment’ value of evidentiality interact at the semantic-pragmatic interface. Our findings shed light on a promising research trajectory for sociolinguistic intervention in the formal, descriptive line of evidentiality research, thus, advancing existing corpus pragmatics literature on evidentiality and epistemics in social-mediated communication.

Race and Ethnicity and Clinician Linguistic Expressions of Doubt in Hospital Admission Notes

Stigmatizing language in electronic health records (EHRs) can generate or reinforce negative stereotypes about patients from minoritized groups and erode their trust and experience. However, less is known about the use of such language to cast doubt on patient clinical history in hospital settings. To compare the prevalence of language expressing doubt about patient clinical history (eg, experiences and symptoms) in hospital admission notes by patient race and ethnicity. In this cohort study, natural language processing tools were applied to analyze 54 936 admission notes from 1249 clinicians about patients aged 18 years or older at admission and hospitalized at an academic health system in the Northeast US between January 1, 2018, and February 28, 2023. Data were analyzed from September 1, 2022, to July 31, 2023. Patient race and ethnicity (non-Hispanic Black, non-Hispanic White, and racial and ethnic minoritized groups excluding non-Hispanic Black [includes multiple racial and ethnic groups, such as Hispanic and Asian]) as recorded in the EHR based on self-report or registrar determination. Binary indicator for at least 1 term casting doubt on patient clinical history was defined using epistemic stance, a linguistic construct expressing a writer's degree of certainty in information. Terms were manually validated via iterative review of notes by the study team. Among 56 325 admission notes (mean [SD] age of patients, 55.9 [19.0] years; 30 913 notes among female patients [54.9%]; 25 649 notes among non-Hispanic Black patients [45.5%], 26 442 notes among non-Hispanic White patients [46.9%], and 2985 notes among members of racial and ethnic minoritized groups excluding non-Hispanic Black patients [5.3%]), we analyzed 54 936 admission notes that had no missing data. Among all analyzed admission notes, 39 023 notes (71.0%) contained doubt language. Notes written about non-Hispanic Black patients had increased odds of containing at least 1 word or phrase of doubt (adjusted odds ratio, 1.21; 95% CI, 1.14-1.28; P < .001) compared with notes among non-Hispanic White patients. Compared with notes among non-Hispanic White patients, notes written about members of racial and ethnic minoritized groups excluding non-Hispanic Black patients had similar odds of containing at least 1 term of doubt. In this study, language casting doubt on patient clinical history was more likely to be found in notes of non-Hispanic Black patients. These results suggest that with the implementation of policies allowing patients full access to their health records, examining clinical documentation standards may be associated with improved patient experience.

‘My English seems not enough’: moving from language deficit views to Kazakhstani CLIL (content and language integrated learning) teachers’ funds of knowledge

ABSTRACT Our paper critiques the native speaker fallacy underpinning state-mandated policies requiring teachers who speak languages other than English to use it as the medium of instruction. Using a centre-based Funds of Knowledge (FoK) lens, we examine how Kazakhstani biology teachers navigate Content and Language Integrated Learning (CLIL) through English Medium Instruction (EMI). A qualitative analysis of teacher reflections, observations, narratives, and focus groups revealed their hybrid epistemic stance discernible in their shift between knowledge transmission and knowledge construction and their flexible linguistic stance when leveraging their students’ Russian and Kazakh linguistic repertoires to contribute to science understanding and learning in EMI. In highlighting CLIL as a travelling policy, our results revealed the complexities of integrating Western educational models into a post-Soviet system, challenging the theory-practice divide, because a centre-based FoK lens redirected our focus from Western standards to the recognition of teachers’ professional identities and EMI pedagogies as both contextually relevant and locally grounded. Hence, our results call for more inclusive and social justice theoretical lenses to bridge and engage with the pedagogical nexus when different linguistic, cultural and epistemological ways of being merge.

How option-listing influences decision-making in orthopedic consultations: a conversation analytic study

ObjectivesExamine which practices orthopedists use to do option-listing, a technique that can facilitate shared decision-making (SDM). MethodsA conversation analytic study of 35 orthopedic consultations with newly referred patients with hip and/or knee osteoarthritis. ResultsOrthopedists implement option-listing in consultations using two organizational principles: 1) A fixed order of options that constitutes a scale (based on the severity of treatment). Presenting this scale (in two possible orders) encodes this fixed order; 2) Options are presented in relation to each other, rather than as individual options to be discussed incrementally. This format provides orthopedists with interactional slots to formulate their professional stance by presenting options as considered but rejected. Patients co-construct this list by taking a recipient role and not responding to the individual items of the list. ConclusionsOption-listing can facilitate SDM, allowing patients to choose amongst options. A drawback is that, while the organizational principles of option-listing allow orthopedists to express a professional opinion, they also place patients in an interactional position in which they have to address the orthopedists’ epistemic stance. On the other hand, patients can use the scale to propose their own preferences. Practical implicationsAwareness of the interactional consequences of option-listing might optimize SDM.

Does ChatGPT Argue Like Students? Bundles in Argumentative Essays

Abstract The advent of ChatGPT, a novel AI-powered language model able to create grammatically accurate and coherent texts, has generated considerable concern among educationalists anxious about its potential to enable cheating among students and to undermine the development of critical thinking, problem-solving, and literacy skills. The similarities and differences between ChatGPT texts and human writing, however, remain underexplored. This study aims to bridge this gap by comparing the use of 3-word bundles in A-level argumentative essays written by British students with those generated by ChatGPT. Our findings show that ChatGPT essays contain a lower frequency of bundles but these have a higher type/token ratio, suggesting that its bundles are more rigid and formulaic. We also found noun and preposition-based bundles are more prevalent in ChatGPT texts, employed for abstract descriptions and to provide transitional and structuring cues. Student essays are characterized by more epistemic stances and authorial presence, crucial in persuasive argumentation. We attribute these distinct patterns in ChatGPT’s output to its processing of vast training data and underlying statistical algorithms. The study points to pedagogical implications for incorporating ChatGPT in writing instruction.

Overexposed other-initiated repair in Mandarin conversation

When the non-trouble-source speaker initiates and even repairs the repairable, s/he might extend the other-initiation or other-correction segment by rejecting or commenting on the trouble source, thus overexposing the trouble source. This study investigates the overexposed other-initiated repair in Mandarin talk-in-interaction. Overexposed other-initiated repairs in Mandarin are executed in a boldfaced manner for a certain interactional reason, which the current research explores from the conversation analytic perspective. Repairables in the current study fall into either error-based or non-error-based ones. Furthermore, the repairables are taken by the interactants as either a common-sense blunder or a moral blunder. In addition, other overexposures reveal the nuanced relation between interactants and their respective epistemic stance in the local interactional environment

A Comparative Study on the Use of Evaluative That Patterns in Abstracts by Expert and Novice Writers

This study investigates the differences in how expert and novice writers use evaluative that-complement clauses in abstracts. The research analyzed 150 research article abstracts and 100 master’s thesis abstracts in the social sciences, applying the model of “evaluative that patterns” with the assistance of the MAXQDA annotation tool and ChatGPT retrieval mode. The analysis reveals that both groups often use this pattern to present their findings, typically attributing evaluations to abstract sources. They primarily express epistemic stances through verbal predicates. However, experts demonstrate significantly greater use of every element (entity, source, stance, and expression) of this feature. Experts are more inclined to use human resources and discourse act verbs and prefer to evaluate prior studies and methods, expressing more tentative stances to foster a dialogic space. These findings suggest that expertise influences rhetorical strategies for evaluating research materials. The study highlights pedagogical implications, offering valuable insights for novice writers in the social sciences to help them understand how to effectively use linguistic resources to convey evaluative claims and establish authoritative authorial stances.

Request for confirmation sequences in German

Abstract In request for confirmation (RfC) sequences, interlocutors negotiate their social positions regarding access and rights to knowledge. The article presents an overview of a quantitative analysis of 200 RfCs and their responses in German conversations to highlight the relevant linguistic resources speakers of the language deployed to position themselves vis-à-vis a confirmable proposition. In German RfCs, modal particles and tags play an important role in expressing the requester’s epistemic stance; explicit inference marking is used less frequently. Responses usually include response tokens (among others doch as a token specialized for disconfirming negatively formatted RfCs) and an expansion. The article shows that such expansions do important work to tailor the response to the situated informational needs of the requester in a cooperative way beyond the constraints of type-conformity.

Expressions of epistemic stance in computer-mediated L2 speaking assessment

Abstract Learner and L2 user corpora are increasingly valued in language testing and assessment as they can inform test design, revision, and validation. This paper illustrates the benefits of using an L2 corpus to explore patterns of epistemic stance marking in computer-mediated speaking tests with no live human interlocutor. Drawing on the British Council-Lancaster Aptis Corpus – comprising over 630,000 words of L2 speech – we explored the frequency of epistemic stance markers (adverbial, adjectival and verbal) across proficiency levels and speaking task types. The analysis revealed that epistemic stance was prevalent in test-taker discourse and that frequency was influenced by L2 proficiency and task type. The findings demonstrate that computer-mediated speaking tests can elicit expressions of epistemic stance in a comparable way to tests which involve human-human interaction. Implications are drawn for examiner training, test preparation, and an enriched understanding of the elements of pragmatic competence that can be elicited in computer-mediated speaking assessment.

On Semirealism, Realism More Generally, and Underlying Epistemic Stances

The commentators in this Special Issue on ‘Epistemology, ontology, and scientific realism’ raise substantial questions about, and objections to, central aspects of my own thinking about semirealism (a proposal for how best to formulate scientific realism), as well as the larger philosophical context in which debates about scientific realism unfold. This larger context concerns the nature of realism more generally and the epistemic stances that underlie our considered opinions of what the sciences are telling us about the ontology of the world. In this paper, I consider my critics’ remarks, and endeavor to lay their criticisms to rest.

Collaborative character searches in L2 Chinese peer writing: sequential design and object affordances

ABSTRACT In light of the growing field of research on writing-in-interaction within an ethnomethodological (EM) and conversation analytic (CA) perspective, which peer writing as a situated activity unfolded by participants, this study investigates how L2 Chinese learners accomplish collaborative character searches during a peer writing task. The analysis shows that learners’ collaborative character search follows a three-phase sequential design: problem-displaying, attention-drawing, and problem-resolving phases, during which they employ various multimodal resources to achieve interactional goals. By using different objects, participants demonstrate their agency in coordinating resources while collaboratively searching for the correct character(s). Furthermore, participants’ interactions with objects provide affordances for a particular point for noticing, transferring the writership, displaying epistemic stance, re-directing attention, and exploring the emergent learnable. This study unveils how L2 Chinese learners do collaborative character searches during peer writing and extends our understanding of the intricate coordination of multimodal resources in collaborative character search work. It contributes to ongoing discussions on (hand)writing-in-interaction within the EM/CA field by illustrating how participants navigate the intricacies of logographic writing while doing writing.

Authoritative and epistemic stance in the construction of conspiracy theories: A case study

What is central to conspiracy theories is the revelation of a hidden or manipulated truth. In addition, the speaker/writer who believes in a conspiracy theory and shares their views on it also seeks the listener’s/reader’s adhesion to the theory. As a result, the speaker/writer must solve two problems: first, the version in which they believe has to be perceived as plausible by the audience and, second, the speaker/writer must have, or gain, credit in order to appear credible. These two aspects are somewhat subsumed under what Biber and Hyland, among others, refer to as stance and stance-taking, which correspond to the positioning of a locutor towards viewpoints and interlocutors. In order to analyze these aspects and the relations between the linguistic markers and the discursive strategies (pragmatic, argumentative, or rhetoric), this study is based on a corpus analysis of online articles written by Jon Rappoport, an unequivocal conspiracy theorist. I only focus on plausibility hedges and certainty boosters so as to study the marking of authoritative and epistemic stance in his discourses and the function(s) they perform. The results show that both plausibility hedges and certainty are used to legitimize Rappoport’s theories and strengthen his authority in various ways, depending on the devices used. Plausibility hedges are mainly used to voice a dissenting interpretation of reality, presented as a possibility that cannot be ruled out, and downplay the elite’s viewpoints. Certainty boosters are used to express the author’s confidence and commitment towards his theories, by presenting his interpretation of reality as unquestionable, self-evident or consensual. Finally, the use of first-person pronouns and booster or hedge verbs are also used to strengthen the legitimacy of the theories and the authority of the author by explicitly indicating his contribution to the construction of conspiracy theories or to introduce and support a dissident viewpoint.

Utilization of Mental Health Provision, Epistemic Stance and Comorbid Psychopathology of Individuals with Complex Post-Traumatic Stress Disorders (CPTSD)-Results from a Representative German Observational Study.

Background: Complex post-traumatic stress disorder (CPTSD) is a severely debilitating recently added symptom cluster in the International Classification of Diseases (ICD-11). So far, only limited information on mental health treatment-uptake and -satisfaction of individuals with CPTSD is available. The aim of this study is to investigate these aspects in a representative sample of the German general population. Methods: Participants completed the International Trauma Questionnaire (ITQ) to identify participants with CPTSD, as well as questionnaires on mental health treatment uptake and satisfaction, adverse childhood experiences, anxiety, depression, working ability, personality functioning, and epistemic trust. Results: Of the included n = 1918 participants, n = 29 (1.5%) fulfilled the criteria for CPTSD. Participants with CPTSD had received mental health treatment significantly more often than participants with PTSD or depression (65.5% vs. 58.8% vs. 31.6%; p = 0.031) but reported significantly less symptom improvement (52.9% vs. 78.0% vs. 80.0%; p = 0.008). Lower levels of epistemic trust were associated with higher CPTSD symptoms (p < 0.001). Conclusions: Our study shows that while the vast majority of individuals with CPTSD had received mental health treatment, subjective symptom improvement rates are not satisfactory. CPTSD was associated with a broad number of comorbidities and impairments in functioning. Lower levels of epistemic trust may partially explain worse treatment outcomes.

Change of Epistemic Stance of Transnational Pre-Service Teachers in-and-through Collaborative Data-Led Reflective Dialogues

This study explored collaborative data-led reflective dialogues of transnational PSTs by using Multimodal Conversation Analysis. The study draws on the screen recordings of a Virtual Exchange (VE) project (n=72), which involves collaborative online task design, implementation of tasks by L2 students, and reflection on students’ performance and their experience of the VE project. The close examination of the data showed that through collaborative reflective dialogues, PSTs (i) raised awareness of their practice and generated knowledge; (ii) made a connection between theory and practice; (iii) became more aware of their epistemic stance; (iv) identified and described a problem and found solutions to these problems (Farrell, 2015). Therefore, micro-moments of learning and understanding were created in-an- through reflection and it was revealed explicitly through reference to lack of knowledge in the past. This study has implications for teacher education programs, which should encourage reflective dialogues of transnational PSTs to create opportunities for teacher learning.

Improvements of complex post-traumatic stress disorder symptoms during a multimodal psychodynamic inpatient rehabilitation treatment – results of an observational single-centre pilot study

ABSTRACT Background: Complex post-traumatic stress disorder (CPTSD) describes chronic disturbances in self-organization (i.e. affect dysregulation; negative self-concept; severe difficulties in relationships) which are frequently observed in survivors of prolonged, repeated or multiple traumatic stressors. So far, evidence of psychodynamic treatment approaches for CPTSD is scarce. Methods: In this single-centre observational pilot study, symptom change during a 6-week psychodynamic inpatient treatment in a multimodal psychosomatic rehabilitation centre was evaluated using repeated measures analyses of variance (ANOVAs). Patients completed questionnaires on PTSD and CPTSD symptoms (ITQ), anxiety, depression and somatization (BSI-18), functional impairment (WHODAS) and epistemic trust, mistrust and credulity (ETMCQ) before (T1) and at the end of treatment (T2). A hierarchical linear regression analysis was calculated to identify factors associated with improved CPTSD symptoms. Results: A total of n = 50 patients with CPTSD were included in the study, of whom n = 40 (80%) completed treatment. Patients reported a significant reduction of CPTSD symptoms during treatment with a large effect size (−3.9 points; p < .001; η 2 = .36), as well as a significant reduction of psychological distress (p < .001; η 2 = .55) and functional impairment (p < .001; η 2 = .59). At the end of treatment, 41.0% of patients no longer fulfilled the diagnostic criteria for CPTSD. Changes in epistemic stance included improved epistemic trust (β = –.34, p = .026) and decreased epistemic credulity (β = .37, p = .017), which together with lower age (β = .43, p = .012) and lower depression levels at baseline (β = .35, p = .054) were significantly associated with baseline adjusted mean change of CPTSD symptoms during therapy and explained 48% of its variance. Discussion: In our study, patients reported a significant reduction of CPTSD symptoms and comorbid symptoms during a multimodal psychodynamic inpatient rehabilitation treatment. Improved epistemic trust may facilitate the establishment of a trusting therapeutic relationship, thus fostering an environment of openness for knowledge transfer (i.e. social learning) and the exploration of diverse viewpoints and perspectives in the therapeutic process.

Towards a sociolinguistics of in difference: stancetaking on others

Abstract This paper proposes a sociolinguistics of in difference, an inquiry-based approach to stancetaking on others. It describes how multilingual speakers in an online context orientate towards a stance-object and affiliate, align and negotiate difference through embodied performances, as part of advancing an ethics of responsibility for the other and aesthetic investments. In the analysis of such orientations, I draw on virtual interactional data to illustrate how in difference through stancetaking is entextualized in the aesthetic, embodied performance of parody, in so-called Coloured English, Kaaps and a mixture of other languages by an emerging R&amp;B and pop group in Cape Town. I demonstrate how the group invest in embodied performances merge the material, linguistic, cultural and semiotic significance of the body to undermine fixity and categorization. But also, how push-back from YouTube commentators, influencers, reactors take up evaluative, affective and epistemic stances as they move from difference to in difference. I conclude with the argument that in order for us to take adequate account of an ethics of responsibility for the other and describing aesthetic investments in embodied performances we have to recalibrate our theoretical and methodological toolkit to understand what it means to use language with dignity, to encounter each other in spaces of dignity and to just be dignified in diversity.

Epistemic Autonomy and the Shaping of Our Epistemic Lives

ABSTRACT I present an account of epistemic autonomy as a distinctively wide-ranging epistemic virtue, one that helps us to understand a range of phenomena that might otherwise seem quite disparate – from the appropriate selection of epistemic methods, stances and topics of inquiry, to the harms of epistemic oppression, gaslighting and related phenomena. The account draws on four elements commonly incorporated into accounts of personal autonomy: (i) self-governance, (ii) authenticity, (iii) self-creation and (iv) independence. I further argue that for a distinctively epistemic virtue of autonomy; the above elements must ultimately reliably lead to valuable epistemic goods (for the agent herself and others). I then turn to the domains or ways in which epistemic autonomy so understood, can be made manifest. I suggest that epistemic autonomy is a virtue that allows us to appropriately choose (i) subject matters and areas of inquiry, (ii) methods, sources, and processes of belief formation, (iii) epistemic goals and (iv) epistemic stances or frameworks. So understood, epistemic autonomy has a role to play in shaping most every aspect of our epistemic lives.

Epistemic stance and public discourse on irregular migration in one of Europe’s outermost regions

Abstract This article falls within the conceptual framework of critical discourse studies and cognitive linguistics whose attention has focused on the discourse found in the public sphere on the topic of migration. I will demonstrate the results of my analysis of a corpus composed of 74 opinion articles that were published in a Spanish regional newspaper between August 2020 and February 2021. All of them focus on the same issue: the mass arrival of irregular migrants at one of Europe’s outermost borders, the Canary Islands, and the social, political and economic strain that this is generating. The results of this analysis indicate that the periphrastic auxiliary verb poder (can/could/might) constitutes an essential resource for the way in which knowledge is managed by the authors whose intention is to fuel the debate by guiding the conceptualisation of reality of readers who do not have perceptual access to the events described.

Linking epistemic stance and problem-solving with self-confidence during play in a puzzle-based video game

Linking epistemic stance and problem-solving with self-confidence during play in a puzzle-based video game