Parasuicide during Ramadan in Jordan

To investigate the impact of national and religious events on the rate of parasuicide, a comparison was made between the number of reported parasuicides during the month of Ramadan and the month before and after Ramadan in Jordan, for the years from 1986 to 1991. Significantly fewer parasuicides were reported during Ramadan than the month preceding it and the month that follows Ramadan. The findings confirm previous observations that national events reduce the rate of parasuicide, but the protective effect does not persist into the month that follows Ramadan.

[Premature ejaculation--results of treatment of men of 2 different cultural backgrounds]

The object of this investigation was to compare Danish and Muslim men treated for premature ejaculation in the Department of Sexology, Rigshospitalet, Copenhagen. The investigation is a retrospective review from the period 1986-1989. The following variables were included in the investigation: Mode of referral, personal data, duration of sexual dysfunction, previous sexological/psychiatric treatment, methods of treatment and results of treatment. The material consists of 60 Danish and 32 Muslim men. The investigation reveals that the Muslim men predominantly receive individual therapy of brief duration. Fewer Muslims were instructed in sensuality training and fewer carry out stop-start-treatment. The Muslim men responded more poorly to treatment than the Danish men. The differences in the therapeutic methods and therapeutic results cannot be explained on the basis of the personal parameters and possible cultural obstacles to treatment are suggested. For example, the therapist must become familiar with taboos and beliefs in the Muslim culture. The referring instance should inform the patients about the therapeutic principles at the Department of Sexology and attempts must be made to motivate possible partners to participate in the treatment.

Mourning the loss of "self as father": a longitudinal study of fatherhood among the Druze

It is within the context of the parent-child relationship--through the processes of attachment, loss, separation and individuation--that we grow and develop interpersonally and intrapsychically (Bowlby 1969, 1980; Mahler et al. 1975; Pollock, 1989). Most developmentalists agree that changes in the parent-child relationship continue to influence both parents and children throughout the life cycle (Cohen et al. 1984; Colarusso and Nemiroff 1982). While there is a vast body of literature devoted to discussing changes that occur in the parent-child relationship during the "formative years," little has been written about what happens to that relationship after the children leave home to start families of their own. Moreover, most researchers investigate the processes of attachment, loss, separation and individuation in terms of the child's development. Little is known about how the child's quest for independence affects the psychological development of his/her parents. Those writers who have addressed the issue of individuation in later life tend to focus on the adult child's continuing struggle to separate and individuate from his/her real or imagined parents (Levinson, 1978).

Psychotherapy of an Arab patient by a Jewish therapist in Israel during the Intifada

Fragments of a psychotherapy of an Arab patient by a Jewish psychotherapist in Israel, during an exacerbation of a historical political conflict, are presented. In addition to the delineated characteristic difficulties embedded in a cross-cultural/ethnic/national psychotherapy, an Arab-Jewish dyad evokes a complicated interaction between external political reality and the therapeutic space, confusing and obscuring the discourse, the transference, and the countertransference. We believe that the complex and intricate relationship between external reality and inner psychic reality, as it appeared in the therapeutic space, endangered the psychotherapeutic process by blurring the boundaries and creating a fertile ground for projective identification. Both the use of political reality as a defense, or its denial may preclude the possibility for a real dialogue. Implications for emphasizing the differences between patient's and therapist's ethnic affiliations, guarding sensitively the authenticity of interaction, and strengthening both participants' identity in all the relevant levels are pointed out to facilitate the dialectic process of the psychotherapy.

The influence of Islamic views on public attitudes towards kidney transplant donation in a Saudi Arabian community

Public attitudes towards organ donation during life and at death were examined in a randomised survey of 850 individuals, both male and female, in a representative Saudi Arabian community in Riyadh. Demographic categories accounted were age, sex, marital status, cultural and ethnic background, educational level and occupation. Of the sampled population 87% were native Saudi and the mean age was 30.7 years. Students and teachers made up the largest occupational groups and only 8.1% were illiterate. Although only 10.1% of all subjects had signed a kidney donor card, a further 42.6% expressed willingness to do so. Acceptance of organ donation at death was highest amongst males and in the age group below 30 years (P less than 0.05). There was no differential effect of the various demographic sub-groups in willingness for kidney donation during life. Sixty-five per cent were ready to donate to a close relative and 9.3% were even prepared to do so to a non-related recipient. The Islamic view supporting concepts of transplantation provided the strongest positive influence for organ donation both during life and at death. Dread of mutilation and the fear that pre-consent may adversely affect treatment after serious injury proved potent negative influences.

Ambiguous genitalia: medical, socio-cultural and religious factors affecting management in Saudi Arabia

Twenty-eight children with ambiguous genitalia were seen at King Khalid University Hospital over a 6-year period. The incidence of this disorder was 0.4/1000 live births. Of the total, 21 (75%) were Saudis and seven (25%) were non-Saudis. The consanguinity rate was 67.9%. Twenty-four (85.7%) were born in hospital and four (14.3%) at home. In only three (10.7%) was the news first broken to the parents by a senior doctor, in 13 (46.4%) by a junior doctor, and in 11 (39.3%) by a nurse. Ambiguous genitalia were observed in 22 (78.6%) at birth and in six (21.4%) were picked up later. Owing to a lack of immediate investigative facilities and for some socio-cultural reasons, 19 of the latter groups were assigned sex without prior investigations. There was an obvious preference to assign male sex. On investigation, 13 (46.4%) had XX chromosomes, 11 (39%) XY and one (3.6%) XO: in three (10.7%), chromosomal results were not available. There were 14 cases (50%) of congenital adrenal hyperplasia, two of 5-alpha reductase deficiency (7.1%), and five of testicular feminization syndrome (17.9%), in addition to others. After investigation, five (17.9%) of the children needed sex reassignment. This was accepted by two and rejected for socio-cultural reasons by three. The opinion of the religious leaders was obtained. Some recommendations on management of these cases are made, based on our local experience.

Cultural differences in the perception of magazine alcohol advertisements by Israeli Jewish, Moslem, Druze and Christian high school students

This article describes the Israeli part of an international comparative research project conducted simultaneously in 1988 also in Australia and in the U.S.A., in order to determine the attitudes of high school students from different nations and cultures toward alcohol advertising. The Israeli study used a set of 64 magazine alcohol advertisements from 10 countries and with the help of an open-ended questionnaire examined differences and similarities in the perception of Israeli and foreign advertisements by Jewish, Moslem, Druze and Christian teenagers. Each response was coded twice. The first code indicated the general tone of the response and the second code indicated its theme. The article presents selected general results and conclusions. The results have implications for designing alcohol abuse education messages and can aid alcohol advertisers interested in responsible advertising to find advertising standards suitable to each culture.

Islam and family planning acceptance in Bangladesh

One frequently cited barrier to more widespread adoption of family planning in Moslem countries is religious opposition. To examine the depth and extent of such opposition in Bangladesh, 106 men who had been identified by their wives as religiously opposed to family planning were interviewed. Unexpectedly, 26 percent of the "opposing" husbands reported that they were current users of a contraceptive and an additional 50 percent, although not practicing, said they were in favor of family planning. Of the alleged "opposers," only 23 percent said they opposed family planning on religious grounds. One-fourth of this last group were able to cite specific islamic injunctions against family planning. It appears on the basis of these data, which were collected in the religiously conservative area of Lakshimipur, that the perception of widespread Islamic-based resistance to contraception in Bangladesh is not founded in fact.

Attitudes of a sector of the Arab-Muslim population in Kuwait towards alcohol and drug misuse: an objective appraisal

The attitude of a sample of 1001 Arab Muslims living in Kuwait towards alcohol and drug misuse was examined by using a 30-item questionnaire. Eighty percent condemned drug misuse, 93.6% thought it was a contravention of Muslim religious teachings, yet 90% held an enlightened attitude compared to only 26% that chose the punitive attitude. The older generation, the less educated, females and Non-Kuwaiti Arabs were less likely to be sympathetic towards substance misusers. These findings while indicating the sample's strong religious condemnation of substance misuse demonstrated the adoption of Western concepts of care especially by the younger educated Kuwaiti males. Indirect evidence of drug misuse and smoking in the sample may be inferred from the low rates of denunciation of such behaviours.

The drinking habits of Sikh, Hindu, Muslim and white men in the West Midlands: a community survey

Men born in India but living in Britain have higher than expected treated prevalence rates of alcohol-related disorders. A community survey of random samples of 200 each of Sikh, Muslim and Hindu men and 200 white English-born men, matched for age, were interviewed using a structural questionnaire containing a retrospective drinking diary. Sikhs were most likely to be regular drinkers followed by whites and Hindus. The very few Muslim men who drank consumed the most alcohol on average. The frequently reported pattern of an inverse relationship between drinking and age was found for white men but not among Sikhs and Hindus. In both these groups older men reported consuming more alcohol than did young men. However, age was confounded with generation: heavier levels of consumption were reported by Sikhs and Hindus born in India than by Sikhs and Hindus born in Britain. Among regular drinkers Sikhs had higher average Alcohol Problem Scale Scores than did white men or Hindus. The highest average scores were recorded for the (few) Muslim regular drinkers (who also consumed the most alcohol). A clear association with religious observance was found for all three Asian groups and for the white men. No religious Muslims drank at all, and a relatively small proportion of the other groups who were regular church/Temple attenders drank regularly.

Screening for alcoholism among alcohol users in a traditional Arab Muslim society

The Short Michigan Alcoholism Screening Test (S-MAST) was applied to 140 alcohol users in the traditional Muslim society of Kuwait. One hundred were confirmed alcoholics and 40 were self-disclosed social drinkers in the community. The questionnaire significantly discriminated between the groups. Its sensitivity level was 100% and its specificity 82.5%. Although all except one of the S-MAST items elicited significant differences between the groups in question, it appears that the particular sociocultural conditions of the setting may influence the validity of some of them.