Cultural consonance: linking culture, the individual and health

Sources of attitudes towards parent-child co-sleeping and their effects: A systematic scoping review

Parent-child co-sleeping is a common practice in many cultures, although in Western countries, families who engage in parent-child co-sleeping can encounter attitudes about co-sleeping that feel critical from the people around them, as it is not commonly accepted and often stigmatized. This systematic scoping review examined and synthesized the available literature on the attitudes about parent-child co-sleeping that people encounter, their origins, and their effect on parents' own attitudes and behaviors. A total of 9796 abstracts were screened, and 33 studies were included. While the scope of the literature on this topic was narrow, this review demonstrated that parents/caregivers mostly encounter encouraging attitudes about co-sleeping from their extended family members and within their culture and discouraging attitudes from healthcare professionals. Findings suggest that encouraging attitudes enhance the likelihood of parents engaging and continuing with co-sleeping behavior, while discouraging attitudes can lead to the avoidance of parents discussing sleep with their healthcare professionals and can cause conflicts with other family members, including partners. Based on these findings, we conclude that further research is needed in several areas related to co-sleeping in Western culture, most specifically in how external attitudes influence the decision to co-sleep, as well as other behaviors and cognitions such as engagement with healthcare professionals, family satisfaction, parental self-efficacy, and overall mental health.

Proximal and distal honor fit and subjective well-being in the Mediterranean region

OBJECTIVE

People's psychological tendencies are attuned to their sociocultural context and culture-specific ways of being, feeling, and thinking are believed to assist individuals in successfully navigating their environment. Supporting this idea, a stronger "fit" with one's cultural environment has often been linked to positive psychological outcomes. The current research expands the cultural, conceptual, and methodological space of cultural fit research by exploring the link between well-being and honor, a central driver of social behavior in the Mediterranean region.

METHOD

Drawing on a multi-national sample from eight countries circum-Mediterranean (N = 2257), we examined the relationship between cultural fit in honor and well-being at the distal level (fit with one's perceived society) using response surface analysis (RSA) and at the proximal level (fit with one's university gender group) using profile analysis.

RESULTS

We found positive links between fit and well-being in both distal (for some, but not all, honor facets) and proximal fit analyses (across all honor facets). Furthermore, most fit effects in the RSA were complemented with positive level effects of the predictors, with higher average honor levels predicting higher well-being.

CONCLUSIONS

Our findings highlight the interplay between individual and environmental factors in honor as well as the important role honor plays in well-being in the Mediterranean region.

Role of country of origin and state of residence for dietary change among foreign-born adults in the US

Place of origin and place of current residence may shape migrants' health-related behaviors. Using the nationally-representative US New Immigrant Survey (n = 7930), we examined associations between country of origin, state of residence, and dietary changes among foreign-born adults. 65% of migrants reported dietary change since immigration (mean score = 7.3; range = 1-10); 6% of the variance was explained by country of origin characteristics; 1.6% by US state of residence; 1.4% by their interaction. Country of origin factors, specifically availability of animal source foods and sweets, were associated with dietary change, availability of sweets also including greater abandonment of specific foods and adoption of others.

Applying minimally invasive biomarkers of chronic stress across complex ecological contexts

Chronic stress is both theoretically and methodologically challenging to operationalize through biomarkers. Yet minimally invasive, field-friendly biomarkers of chronic stress are valuable in research linking biology and culture, seeking to understand differential patterns of human development across ecological contexts, and exploring the evolution of human sociality. For human biologists, a central question in measurement and interpretation of biomarkers is how stress-responsive physiological systems are regulated across diverse human ecologies. This article aims to describe a conditional toolkit for human biologists interested in the study of chronic stress, highlighting a mix of longstanding and novel biomarkers, with special focus on hair/fingernail cortisol, latent herpesvirus antibodies, allostatic load indices, and serial/ambulatory data collection approaches. Future trends in chronic stress biomarker research, including epigenetic approaches, are briefly considered. This overview considers: (1) challenges in separating a distinctly psychosocial dimension of chronic stress from adversity more broadly; (2) essential characteristics of human ecology that shape interpretation; (3) retrospective vs. longitudinal sampling; (4) the role of age, developmental effects, and local biologies; (5) different timescales of chronicity; and (6) the role of culture.

What is the expected human childhood? Insights from evolutionary anthropology

In psychological research, there are often assumptions about the conditions that children expect to encounter during their development. These assumptions shape prevailing ideas about the experiences that children are capable of adjusting to, and whether their responses are viewed as impairments or adaptations. Specifically, the expected childhood is often depicted as nurturing and safe, and characterized by high levels of caregiver investment. Here, we synthesize evidence from history, anthropology, and primatology to challenge this view. We integrate the findings of systematic reviews, meta-analyses, and cross-cultural investigations on three forms of threat (infanticide, violent conflict, and predation) and three forms of deprivation (social, cognitive, and nutritional) that children have faced throughout human evolution. Our results show that mean levels of threat and deprivation were higher than is typical in industrialized societies, and that our species has experienced much variation in the levels of these adversities across space and time. These conditions likely favored a high degree of phenotypic plasticity, or the ability to tailor development to different conditions. This body of evidence has implications for recognizing developmental adaptations to adversity, for cultural variation in responses to adverse experiences, and for definitions of adversity and deprivation as deviation from the expected human childhood.

Considering Cultural Consonance in Trustworthiness of Online Hotel Reviews among Generation Y for Sustainable Tourism: An Extended TAM Model

This study aims to predict Generation Y customers’ acceptance of user-generated content (UGC) websites by integrating an extended technology acceptance model (TAM), trustworthiness of online reviews, and cultural consensus and cultural consonance theory. To collect data, a free listing method was first used to recognize our ad hoc domain, i.e., the factors that determine the trustworthiness of online hotel reviews among Generation Y in South Korea, from an emic perspective. Based on the free listing results from 39 individuals, an online survey was conducted with 273 samples using a self-administered questionnaire. Cultural consensus analysis was conducted to determine whether there is a shared cultural model in trustworthiness factors among participants, and cultural consonance values were calculated. Then, a structural equation modeling technique was used to estimate how the proposed model explains the collected data. Results indicate that an agreed-upon cultural model of trustworthiness of online hotel reviews exists among sample members. Cultural consonance of trustworthiness was found to constitute a significant antecedent of perceived ease of use and attitude towards websites in the extended TAM model. This study can contribute to predict Generation Y customers’ acceptance of UGC websites and offer meaningful implications for sustainable tourism management, particularly when cultural variables are considered.

Cultural Scripts of Traumatic Stress: Outline, Illustrations, and Research Opportunities

As clinical-psychological scientists and practitioners increasingly work with diverse populations of traumatized people, it becomes increasingly important to attend to cultural models that influence the ways in which people understand and describe their responses to trauma. This paper focuses on potential uses of the concept of cultural script in this domain. Originally described by cognitive psychologists in the 1980s, scripts refer to specific behavioral and experiential sequences of elements such as thoughts, memories, attention patterns, bodily sensations, sleep abnormalities, emotions and affective expressions, motivation, coping attempts, and ritualized behaviors that are relevant to posttraumatic adjustment. We differentiate between experiences of traumatic stress that are scripted (e.g., cultural explanations are available) versus unscripted. Further characteristics such as script tracks, the effect of script interruptions, and contextual fit of scripts with other cultural models are also described. We consider examples of traumatic stress associated with war and organized, sexualized violence from "Western" and "non-Western" world regions. The concluding part of this review describes a number of possibilities for methodological approaches to assessment of cultural scripts. Capturing central elements of the script(s) of trauma would aid psychological researchers and clinicians in understanding the experiences of trauma in cultural context, which could ultimately lead to better clinical service opportunities worldwide.

Body Image Models among Low-income African American Mothers and Daughters in the Southeast United States

Obesity among low-income African American women has been studied using the concepts of both satisfaction and acceptance. The satisfaction frame suggests greater satisfaction with their bodies than their white counterparts, irrespective of size. The acceptance frame suggests that alternative aesthetics serve as resistance against intersectional marginalization. Yet, while these women accept their body size in defiance of thinness ideals, they may not be satisfied. We describe cultural models of body image among mothers and daughters in Alabama. We found that respectability, material consumption, and parental support were important factors determining positive body image, exceeding descriptions of physical features. We further found that those expressing greater body dissatisfaction emphasized respectability, whereas those with less dissatisfaction assigned importance to consumerism and physical form. These findings suggest divergences between biomedical messaging and lived experience. They also challenge uncritical or universalist applications of these frames when interpreting African American women's perceptions of their own bodies.

Determinación social del proceso salud-enfermedad: una mirada crítica desde la epidemiología del siglo XXI

La llamada determinación social es un concepto central de la Medicina Social Latinoamericana (MSL). Son frecuentes las críticas que la MSL hace a la epidemiología, principalmente por su visión reduccionista y su lejanía a la realidad social. En este ensayo se hace un análisis contrario: la epidemiología del siglo XXI hace una crítica a la MSL, usando como ejemplo el desarrollo disciplinar en Colombia. Se revisa la historia de la epidemiología colombiana indicando que no ha tenido desarrollo suficiente y la MSL tiende a rechazar los métodos cuantitativos con fundamento en la práctica epidemiológica de hace cuatro décadas. Se revisan algunos desarrollos en los métodos cuantitativos usados en epidemiología, indicando que se han superado varias de las limitaciones señaladas por la MSL. Se concluye que la MSL usa la determinación social como parte de su plataforma política de izquierda; sin embargo, los métodos cuantitativos actuales y los desarrollos teóricos en epidemiología del siglo XXI evidencian una superioridad pragmática, útil para solucionar las problemáticas de la salud pública actual.

Cultural consonance, deprivation, and psychological responses for niche construction

Cultural consonance is a measure of culturally encoded goals relevant to psychological, behavioral, and health responses to deprivation. Similar to extrinsic mortality, low cultural consonance and an associated inability to predict adaptive outcomes may activate impulsivity, delay discounting, and reward seeking. Low cultural consonance could promote “fast life history” in low-quality environments and motivate cultural niche construction for local adaptation.

Cultural influences on the management of environmental health risks among low-income pregnant women

Following environmental health disasters such as Hurricane Katrina and the Gulf Oil Spill, U.S. Gulf residents expressed concern regarding air quality. Women with children make many decisions that mitigate household air quality risks; however, research examining culture's influence in their risk perception and the influence which this has on their behaviour is limited. In this article we examine the cultural connection between low-income women with children along the U.S. Gulf concerning the local threat of air quality. We used cultural consensus analysis to examine the perceptions of low-income, first-time pregnant women. We undertook an interview survey of 112 women living in Southeast Louisiana, USA between May 2014 and March 2015. In this article we examine if there was a shared (cultural) understanding among these women on how to manage air quality threats, to evaluate what determined cultural sharing in the group, and to explore what role cultural beliefs played in their intended household strategies. We found that although air quality was rarely discussed by the women in our study, we were able to identify two multi-centric cultural models of how these women sought to make sense of air quality issues. In one model they relied on their immediate social network of family and friends while in the other model they were willing to make use of official sources of information. These two models helped explain what measures these women planned to take to address air quality issues in an around their household. Our findings show that cultural norms permeate the assessment of risk in a community and that programmes designed to improve public health need to take into account the cultural context of the population.

Biocultural research in global mental health: mapping idioms of distress onto blood pressure in a population survey

OBJECTIVES

Biocultural research remains a challenge in the field of global mental health. We sought to test associations between blood pressure and idioms of distress in a population survey.

METHODS

We drew on a randomly selected sample of 991 adults (498 men, 493 women) in Afghanistan, for whom physiological and psychosocial data were systematically collected. Assessment of mental health (Self-Reported Questionnaire, Afghan Symptom Checklist) included conceptualizations of distress related to pressure (fishar), anxiety, and dysphoria, as well as dimensions of negative affect and aggression. We used principal component analysis to map survey responses to fishar, and multiple regressions to examine associations with systolic/diastolic blood pressure, controlling for age, body mass index, and wealth, and differentiating by gender, mental health, and medication.

RESULTS

The Afghan sample averaged 129/80 mmHg, with 27.14% of hypertensive individuals. SBP showed inverse associations with reports of low fishar (β = -4.58, P < .001) and high fishar (β = 6.90, P < .001), as did DPB with low fishar (β = -1.55, P < .001) and high fishar (β = 3.77, P < .001). Low and high fishar responses accounted for substantial proportions of SBP data variation (R²  = 20% and R²  = 24%), especially in adults on blood pressure medication (R²  = 58% and R²  = 49%).

CONCLUSIONS

Subjective reports of fishar map onto physiological blood pressure more robustly than other conceptualizations of mental distress related to anxiety, dysphoria, negative affect, or aggression. Our results point to the utility of mapping biological and cultural measures of stress and distress, advancing biopsychosocial understandings of wellbeing in global mental health surveys.

Destigmatization and health: Cultural constructions and the long-term reduction of stigma

Research on the societal-level causes and consequences of stigma has rarely considered the social conditions that account for destigmatization, the process by which a group's worth and status improve. Destigmatization has important implications for the health of stigmatized groups. Building on a robust line of stigma reduction literature in psychology, we develop a sociological framework for understanding how new cultural constructions that draw equivalences and remove blame shape public and structural stigma over time. We examine historical transformations of cultural constructions surrounding three stigmatized groups in the United States: people living with HIV/AIDS, African Americans, and people labeled as obese. By tracing this process across cases, we find that the conditions that account for destigmatization include the credibility of new constructions, the status and visibility of actors carrying these constructions, the conclusiveness of expert knowledge about stigmatized groups, the interaction between new constructions and existing cultural ideologies, and the perceived linked fate of the stigmatized and dominant groups. We also find that the reduction of structural and public forms of stigma often depend on distinct processes and constructions. To conclude, we propose a framework for the comparative study of destigmatization as an essential component of promoting a culture of health.

Feeling right is feeling good: psychological well-being and emotional fit with culture in autonomy- versus relatedness-promoting situations

The current research tested the idea that it is the cultural fit of emotions, rather than certain emotions per se, that predicts psychological well-being. We reasoned that emotional fit in the domains of life that afford the realization of central cultural mandates would be particularly important to psychological well-being. We tested this hypothesis with samples from three cultural contexts that are known to differ with respect to their main cultural mandates: a European American (N = 30), a Korean (N = 80), and a Belgian sample (N = 266). Cultural fit was measured by comparing an individual's patterns of emotions to the average cultural pattern for the same type of situation on the Emotional Patterns Questionnaire (De Leersnyder et al., 2011). Consistent with our hypothesis, we found evidence for "universality without uniformity": in each sample, psychological well-being was associated with emotional fit in the domain that was key to the cultural mandate. However, cultures varied with regard to the particular domain involved. Psychological well-being was predicted by emotional fit (a) in autonomy-promoting situations at work in the U.S., (b) in relatedness-promoting situations at home in Korea, and (c) in both autonomy-promoting and relatedness-promoting situations in Belgium. These findings show that the experience of culturally appropriate patterns of emotions contributes to psychological well-being. One interpretation is that experiencing appropriate emotions is itself a realization of the cultural mandates.

The resilience activation framework: a conceptual model of how access to social resources promotes adaptation and rapid recovery in post-disaster settings

A number of governmental agencies have called for enhancing citizens' resilience as a means of preparing populations in advance of disasters, and as a counterbalance to social and individual vulnerabilities. This increasing scholarly, policy, and programmatic interest in promoting individual and communal resilience presents a challenge to the research and practice communities: to develop a translational framework that can accommodate multidisciplinary scientific perspectives into a single, applied model. The Resilience Activation Framework provides a basis for testing how access to social resources, such as formal and informal social support and help, promotes positive adaptation or reduced psychopathology among individuals and communities exposed to the acute collective stressors associated with disasters, whether human-made, natural, or technological in origin. Articulating the mechanisms by which access to social resources activate and sustain resilience capacities for optimal mental health outcomes post-disaster can lead to the development of effective preventive and early intervention programs.

Systematic review of behavioural interventions with culturally adapted strategies to improve diet and weight outcomes in African American women

Behavioural interventions incorporating features that are culturally salient to African American women have emerged as one approach to address the high rates of obesity in this group. Yet, the systematic evaluation of this research is lacking. This review identified culturally adapted strategies reported in behavioural interventions using a prescribed framework and examined the effectiveness of these interventions for diet and weight outcomes among African American women. Publications from 1 January 1990 through 31 December 2012 were retrieved from four databases, yielding 28 interventions. Seventeen of 28 studies reported significant improvements in diet and/or weight change outcomes in treatment over comparison groups. The most commonly identified strategies reported were 'sociocultural' (reflecting a group's values and beliefs) and 'constituent involving' (drawing from a group's experiences). Studies with significant findings commonly reported constituent-involving strategies during the formative phases of the intervention. Involving constituents early on may uncover key attributes of a target group and contribute to a greater understanding of the heterogeneity that exists even within racial/ethnic groups. Available evidence does not, however, explain how culturally adapted strategies specifically influence outcomes. Greater attention to defining and measuring cultural variables and linking them to outcomes or related mediators are important next steps.

Cultural and socio-economic conditions as factors contributing to chronic stress in sub-Saharan African communities

Stress is known to contribute to overall health status. Many individuals in sub-Saharan Africa are believed to be stressed about their employment, income, and health. This study aimed to investigate hair cortisol as a biomarker of chronic stress in settlement communities in Kenya. Hair samples were collected from 108 volunteers from settlement communities in Kenya. An enzyme-linked immunosorbent assay technique was used to measure hair cortisol concentrations. In parallel, a health survey was completed. The mean ± SD for the cortisol concentration in the hair of volunteers from the settlement communities in Naivasha was 639 ± 300 ng/g, which was higher than found for a Caucasian reference group (299 ± 110 ng/g; one-way ANOVA, P = 0.0003). There were no differences in hair cortisol concentrations between members of slum settlements adjacent to large floriculture farms in Naivasha (Karagita, Kamere/Kwa Muhia/DCK, and Kasarani) compared with those well-removed from all floriculture in Mogotio (Mogotio and Westlands/Katorongot). However, hair cortisol concentrations were significantly higher in females, divorced volunteers, those who made below minimum wage, and those who reported feeling unsafe collecting water or using sanitation facilities within these 2 settlement groups. We found no evidence for increased chronic stress (measured by hair cortisol content) between members of slum settlements adjacent to versus distant to large floriculture farms. Cultural and socio-economic conditions that prevail in much of sub-Saharan Africa were found to be factors contributing to chronic stress.

The resilience activation framework: a conceptual model of how access to social resources promotes adaptation and rapid recovery in post-disaster settings

A number of governmental agencies have called for enhancing citizens' resilience as a means of preparing populations in advance of disasters, and as a counterbalance to social and individual vulnerabilities. This increasing scholarly, policy, and programmatic interest in promoting individual and communal resilience presents a challenge to the research and practice communities: to develop a translational framework that can accommodate multidisciplinary scientific perspectives into a single, applied model. The Resilience Activation Framework provides a basis for testing how access to social resources, such as formal and informal social support and help, promotes positive adaptation or reduced psychopathology among individuals and communities exposed to the acute collective stressors associated with disasters, whether human-made, natural, or technological in origin. Articulating the mechanisms by which access to social resources activate and sustain resilience capacities for optimal mental health outcomes post-disaster can lead to the development of effective preventive and early intervention programs.

A cultural lens to understanding daily experiences with type 2 diabetes self-management among clinic patients in M'bour, Senegal

Diabetes is a steadily increasing threat in Sub-Saharan Africa (SSA). Factors such as urbanization, obesity, physical inactivity, and inadequate access to healthcare are believed to contribute to the increasing burden of diabetes. Interventions that optimize diabetes self-management are critically important since obtaining diabetes medications is challenging due to cost constraints and availability. Culture is a significant factor in shaping health behaviors such as diabetes self-management, where individual health behaviors operate in confluence with family, community, and social structures. This study examined experiences with diabetes self-management among clinic patients residing in M'bour, Senegal, using the PEN3 model as a cultural framework. Results indicate that financial challenges related to accessing medical care and adhering to the prescribed diabetic diet were the main barriers to diabetes management. Family dynamics serve as both supportive and inhibiting forces that influence the aforementioned barriers.

CULTURAL PHENOMENA AND THE SYNDEMIC FACTOR: SUBSTANCE ABUSE, VIOLENCE, HIV, AND DEPRESSION AMONG HISPANIC WOMEN

Researchers exploring the health of Hispanics in South Florida utilizing a combination of qualitative and quantitative research methods have identified that substance abuse, violence, risky sexual behavior, and depression are not only conceptualized as tightly interrelated health and social problems, but also hold together in a measurement model to represent an underlying phenomenon (i.e., the Syndemic Factor). The purpose of this study is to test hypothesized relationships between cultural phenomena and the Syndemic Factor among community-dwelling Hispanic women. Standardized questionnaires assessing Acculturation, Hispanic Stress, Familism, and the Syndemic Factor were administered to a cross-sectional sample of 548 Hispanic women from South Florida. Structural equation modeling was used to analyze relationships. The model explained 61 percent of the variance in the Syndemic Factor. There was a large positive relationship between the Syndemic Factor and Hispanic Stress, and a small inverse relationship between the Syndemic Factor and Familism. Women with high Hispanic Acculturation and low U.S. Acculturation scored lower on the Syndemic Factor than Integrated/Bicultural women. Familism buffered the relationship between Hispanic Stress and the Syndemic Factor. Structural, community, family, and individual prevention strategies that address underlying conditions associated with the Syndemic Factor must be developed and formally evaluated.

Population disparities in mental health: insights from cultural neuroscience

By 2050, nearly 1 in 5 Americans (19%) will be an immigrant, including Hispanics, Blacks, and Asians, compared to the 1 in 8 (12%) in 2005. They will vary in the extent to which they are at risk for mental health disorders. Given this increase in cultural diversity within the United States and costly population health disparities across cultural groups, it is essential to develop a more comprehensive understanding of how culture affects basic psychological and biological mechanisms. We examine these basic mechanisms that underlie population disparities in mental health through cultural neuroscience. We discuss the challenges to and opportunities for cultural neuroscience research to determine sociocultural and biological factors that confer risk for and resilience to mental health disorders across the globe.