1
|
Keating CT, Hickman L, Geelhand P, Takahashi T, Leung J, Monk R, Schuster B, Rybicki A, Girolamo TM, Clin E, Papastamou F, Belenger M, Eigsti IM, Cook JL, Kosaka H, Osu R, Okamoto Y, Sowden-Carvalho S. Cross-cultural variation in experiences of acceptance, camouflaging and mental health difficulties in autism: A registered report. PLoS One 2024; 19:e0299824. [PMID: 38507392 PMCID: PMC10954134 DOI: 10.1371/journal.pone.0299824] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Accepted: 02/15/2024] [Indexed: 03/22/2024] Open
Abstract
Recent findings suggest that stigma and camouflaging contribute to mental health difficulties for autistic individuals, however, this evidence is largely based on UK samples. While studies have shown cross-cultural differences in levels of autism-related stigma, it is unclear whether camouflaging and mental health difficulties vary across cultures. Hence, the current study had two aims: (1) to determine whether significant relationships between autism acceptance, camouflaging, and mental health difficulties replicate in a cross-cultural sample of autistic adults, and (2) to compare these variables across cultures. To fulfil these aims, 306 autistic adults from eight countries (Australia, Belgium, Canada, Japan, New Zealand, South Africa, the United Kingdom, and the United States) completed a series of online questionnaires. We found that external acceptance and personal acceptance were associated with lower levels of depression but not camouflaging or stress. Higher camouflaging was associated with elevated levels of depression, anxiety, and stress. Significant differences were found across countries in external acceptance, personal acceptance, depression, anxiety, and stress, even after controlling for relevant covariates. Levels of camouflaging also differed across countries however this effect became non-significant after controlling for the covariates. These findings have significant implications, identifying priority regions for anti-stigma interventions, and highlighting countries where greater support for mental health difficulties is needed.
Collapse
Affiliation(s)
- Connor Tom Keating
- Centre for Developmental Science, School of Psychology, University of Birmingham, Birmingham, United Kingdom
| | - Lydia Hickman
- Centre for Developmental Science, School of Psychology, University of Birmingham, Birmingham, United Kingdom
| | - Philippine Geelhand
- ACTE (Autism in Context: Theory and Experiment) at LaDisco (Center for Linguistics Research) and ULB Neuroscience Institute, Université libre de Bruxelles, Brussels, Belgium
| | - Toru Takahashi
- Faculty of Human Sciences, Waseda University, Tokorozawa, Japan
| | - Joan Leung
- School of Psychology, University of Auckland, Auckland, New Zealand
| | - Ruth Monk
- Autistic Member of the Autism New Zealand Community Advisory Group, New Zealand/School of Medical Sciences, University of Auckland, Auckland, New Zealand
| | - Bianca Schuster
- Centre for Developmental Science, School of Psychology, University of Birmingham, Birmingham, United Kingdom
- Department of Cognition, Emotion and Methods in Psychology, University of Vienna, Vienna, Austria
| | - Alicia Rybicki
- Centre for Developmental Science, School of Psychology, University of Birmingham, Birmingham, United Kingdom
| | - Teresa Marie Girolamo
- School of Speech, Language, and Hearing Sciences, San Diego State University, San Diego, CA, United States of America
| | - Elise Clin
- ACTE (Autism in Context: Theory and Experiment) at LaDisco (Center for Linguistics Research) and ULB Neuroscience Institute, Université libre de Bruxelles, Brussels, Belgium
| | - Fanny Papastamou
- ACTE (Autism in Context: Theory and Experiment) at LaDisco (Center for Linguistics Research) and ULB Neuroscience Institute, Université libre de Bruxelles, Brussels, Belgium
| | - Marie Belenger
- ACTE (Autism in Context: Theory and Experiment) at LaDisco (Center for Linguistics Research) and ULB Neuroscience Institute, Université libre de Bruxelles, Brussels, Belgium
| | - Inge-Marie Eigsti
- Department of Psychological Sciences, University of Connecticut, Storrs, CT, United States of America
| | - Jennifer Louise Cook
- Centre for Developmental Science, School of Psychology, University of Birmingham, Birmingham, United Kingdom
| | - Hirotaka Kosaka
- Department of Neuropsychiatry, University of Fukui, Fukui, Japan
| | - Rieko Osu
- Faculty of Human Sciences, Waseda University, Tokorozawa, Japan
| | - Yuko Okamoto
- Waseda Institute for Advanced Study, Waseda University, Tokyo, Japan
| | - Sophie Sowden-Carvalho
- Centre for Developmental Science, School of Psychology, University of Birmingham, Birmingham, United Kingdom
| |
Collapse
|
2
|
Sarkar S, Gupta P, Sahu A, Anwar N, Sharan P. A qualitative phenomenological exploration of prolonged grief in New Delhi, India. Transcult Psychiatry 2023; 60:929-941. [PMID: 37993997 DOI: 10.1177/13634615231213838] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2023]
Abstract
Prolonged grief disorder (PGD) is a condition characterized by difficulty in coping effectively with the loss of loved ones. The proposed diagnostic criteria for PGD have been based predominantly on research from developed Western nations. The cultural variations associated with experience and expression of grief and associated mourning rituals have not been considered comprehensively. The current study aimed to understand the experience of prolonged grief in India through a qualitative enquiry with mental health professionals (focus group discussions) and affected individuals (key informant interviews). Several novel findings diverging from the current understanding of manifestation and narratives of PGD emerged from the study, including differences in the social contexts of bereavement and culture-specific magico-religious beliefs and idioms of distress. The findings point to limitations of existing diagnostic systems for PGD. The results of this study suggest that the assumption of content equivalence for psychiatric disorders across cultures may not be justified and that there is a need to develop culturally sensitive diagnostic criteria and assessment scales for PGD.
Collapse
Affiliation(s)
- Siddharth Sarkar
- National Drug Dependence Treatment Centre, All India Institute of Medical Sciences, New Delhi, India
| | - Prashant Gupta
- Department of Psychiatry, All India Institute of Medical Sciences, New Delhi, India
| | - Anamika Sahu
- Department of Psychiatry, All India Institute of Medical Sciences, New Delhi, India
| | - Nazneen Anwar
- World Health Organization - South East Asia Regional Office, New Delhi, India
| | - Pratap Sharan
- Department of Psychiatry, All India Institute of Medical Sciences, New Delhi, India
| |
Collapse
|
3
|
Au-Yeung A, Marfatia D, Beers K, General DA, McQueen KCD, Martin-Hill D, Wekerle C, Green TJ. Exploring the feasibility of a mental health application (JoyPop TM) for Indigenous youth. Front Psychiatry 2023; 14:1269347. [PMID: 37867769 PMCID: PMC10588183 DOI: 10.3389/fpsyt.2023.1269347] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2023] [Accepted: 09/15/2023] [Indexed: 10/24/2023] Open
Abstract
Objective The purpose of the current study was to explore the acceptability and feasibility of a resilience-focused mobile application, JoyPop™, for use with Indigenous youth. Methods A Haudenosaunee community-based research advisory committee co-developed the research project, in accordance with OCAP™ principles. Adopting a mixed-method approach, five youths from an immersion school used the JoyPop™ app for four consecutive weeks, as well as completed pre-test questions and weekly usage surveys. Most participants also completed post-test questions and a semi-structured interview. Based on a semi-structured interview protocol, youth responded to questions, and the most common themes were categorized to capture the experience of using the app. Results All youth reported a positive impression, used the app daily, found it easy to navigate, and indicated that they would recommend it to a friend. All features were uniformly positively endorsed. There were features that youth used most often (Deep Breathing, "SquareMoves" game, and Art features) and moderately (Rate My Mood, Journaling, and SleepEase). The social connection feature, Circle of Trust, was least utilized, with youth reporting a preference for in-person problem-solving. The drop-down menu of crisis helplines was not used. Youth recommended more gaming options. In terms of cultural resonance, appreciation for the app's use of water sounds in the SleepEase feature was expressed, as was cultural consistency with the "Good Mind" perspective. Recommendations included additional nature sounds, Indigenous design elements, the inclusion of Native language words, and traditional stories. Discussion The JoyPop™ app was positively received by Six Nations youth, and ways to ensure its cultural appropriateness were identified. Moving forward, it is recommended that Indigenous designers create a new version with community design co-creation. Additional research with various groups of Indigenous youth is warranted as a pan-Indigenous approach is not recommended.
Collapse
Affiliation(s)
- Allison Au-Yeung
- Department of Family and Community Medicine, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Daksha Marfatia
- Department of Biochemistry and Biomedical Sciences, Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada
| | - Kamryn Beers
- Department of Health, Aging and Society, Faculty of Social Sciences, McMaster University, Hamilton, ON, Canada
| | | | | | - Dawn Martin-Hill
- Department of Anthropology, Indigenous Studies Program, McMaster University, Hamilton, ON, Canada
| | - Christine Wekerle
- Department of Pediatrics, Department of Psychiatry and Behavioural Neurosciences, Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada
- Optentia Research Unit, North-West University, Potchefstroom, South Africa
| | | |
Collapse
|
4
|
Mahajan P, Patil V. 'College choice' under the COVID-19 pandemic: Sustainability of engineering campuses for future enrollments. PLoS One 2023; 18:e0291876. [PMID: 37756345 PMCID: PMC10530044 DOI: 10.1371/journal.pone.0291876] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Accepted: 09/07/2023] [Indexed: 09/29/2023] Open
Abstract
Engineering profession for students and diverse students for Engineering Campuses (ECs) is the prestige to have for both. Worldwide higher education has been impacted by COVID-19 pandemic, but particularly pulling padlocked doors of Indian engineering campuses (ECs) down. Students' attitudes regarding choice, liking, and preferences were also affected. Knowing how tough 'college choice' was before the pandemic, one can guess how difficult it will be today. The objective of this study was to explore students' perceptions of choice characteristics related to ECs and diverse students enabling choice decisions under the COVID-19 situation, and to discover any possible relationships among them. Research questions were qualitatively examined with the statistical confirmation of related hypothesizes by utilizing ANOVA and Regression analysis. A self-reported quantitative survey composed of a closed-ended structured questionnaire was administered on the students of first-year engineering who had recently enrolled in ECs of North Maharashtra Region of India, after pandemic hitting India. According to the study, ECs have several characteristics impacting students' selection of ECs under pandemic. The influence of proximity, image and reputation, educational quality, and curriculum delivery was significant in contributing sustainability of ECs. This influence was significant across students' psychological and behavioural biases on likes, choices, and preferences. Furthermore, multiple relationships were noted within the sub-groups of demographic, geographic, socioeconomic, academic performance, and psychological and behavioural traits due to the impact of ECs' characteristics on sustainability. The study has provided a framework for policymakers and administrators to strengthen repositioning towards sustainability while capturing potentially diverse enrolments. Even if we have to coexist with pandemic forever or with more similar pandemics, the findings of this study may undergo a fundamental transformation for ECs (existing and forthcoming). On the other hand, by understanding the importance and relations of choice characteristics may smoothen the complex nature of "college choice" for prospective students.
Collapse
Affiliation(s)
| | - Vaishali Patil
- Institute of Management Research and Development, RCPET’s, Shirpur, India
| |
Collapse
|
5
|
Jin L, Compton SE, Sameen DE, Cornish MV, Contractor AA. Mental Health Symptom Profiles and Treatment Parameters Among Asian Indians: Latent Profile Analyses. Int J Ment Health Addict 2023. [DOI: 10.1007/s11469-023-01040-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/29/2023] Open
|
6
|
Sarwar A, Islam MA, Mohiuddin M, Tareq MA, Siddika A. Social Connections and Self-Perceived Depression: An Enhanced Model for Studying Teenagers' Mental Wellbeing. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:15791. [PMID: 36497866 PMCID: PMC9739207 DOI: 10.3390/ijerph192315791] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Revised: 11/23/2022] [Accepted: 11/24/2022] [Indexed: 06/17/2023]
Abstract
The rising prevalence of depression among teenagers in Malaysia as well as globally makes it a vital issue to study. The purpose of this research is to examine the effects of social connection and self-perceived depression towards the improved mental wellbeing of the teenagers of Malaysia. Moreover, the mediating role of self-perceived depression on the improvement of the mental wellbeing of teenagers is examined in this study. This study followed a questionnaire-based approach. The sample of this study included 289 students aged between 15 and 19 years from Klang Valley, Malaysia. Prior permission was obtained from school authorities as well as from parents to allow their children to participate in the survey. To find out the structural relationship between the variables, PLS-SEM was utilized. This study finds that stronger social connections with family and friends may result in reduced self-perceived depression among Malaysian teenagers. Moreover, self-perceived depression among the teenagers surveyed had a negative effect on their improved mental wellbeing. The findings of this study will significantly affect how depression theories are currently understood and have consequences for social work, services, and policy interventions regarding teenagers in Malaysia.
Collapse
Affiliation(s)
- Abdullah Sarwar
- Faculty of Management, Multimedia University, Cyberjaya 63100, Malaysia
| | - Md. Amirul Islam
- Faculty of Management, Multimedia University, Cyberjaya 63100, Malaysia
| | - Muhammad Mohiuddin
- Faculty of Business Administration, Laval University, Quebec City, QC G1V0A6, Canada
| | - Mohammad Ali Tareq
- Department of Finance, Faculty of Business and Economics, University Malaya, Kuala Lumpur 50603, Malaysia
| | - Aysa Siddika
- Faculty of Management, Multimedia University, Cyberjaya 63100, Malaysia
| |
Collapse
|
7
|
Keating CT, Hickman L, Geelhand P, Takahashi T, Leung J, Schuster B, Rybicki A, Girolamo TM, Clin E, Papastamou F, Belenger M, Eigsti IM, Cook JL, Kosaka H, Osu R, Okamoto Y, Sowden S. Global perspectives on autism acceptance, camouflaging behaviours and mental health in autism spectrum disorder: A registered report protocol. PLoS One 2021; 16:e0261774. [PMID: 34969045 PMCID: PMC8718008 DOI: 10.1371/journal.pone.0261774] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Accepted: 12/09/2021] [Indexed: 12/03/2022] Open
Affiliation(s)
- Connor Tom Keating
- School of Psychology, University of Birmingham, Birmingham, United Kingdom
| | - Lydia Hickman
- School of Psychology, University of Birmingham, Birmingham, United Kingdom
| | - Philippine Geelhand
- ACTE (Autism in Context: Theory and Experiment) at LaDisco (Center for Linguistics Research) and ULB Neuroscience Institute, Université libre de Bruxelles, Brussels, Belgium
| | - Toru Takahashi
- Faculty of Human Sciences, Waseda University, Tokorozawa, Japan
| | - Joan Leung
- School of Psychology, University of Aukland, Aukland, New Zealand
| | - Bianca Schuster
- School of Psychology, University of Birmingham, Birmingham, United Kingdom
| | - Alicia Rybicki
- School of Psychology, University of Birmingham, Birmingham, United Kingdom
| | - Teresa Marie Girolamo
- Department of Psychological Sciences, University of Connecticut, Storrs, Mansfield, Connecticut, United States of America
| | - Elise Clin
- ACTE (Autism in Context: Theory and Experiment) at LaDisco (Center for Linguistics Research) and ULB Neuroscience Institute, Université libre de Bruxelles, Brussels, Belgium
| | - Fanny Papastamou
- ACTE (Autism in Context: Theory and Experiment) at LaDisco (Center for Linguistics Research) and ULB Neuroscience Institute, Université libre de Bruxelles, Brussels, Belgium
| | - Marie Belenger
- ACTE (Autism in Context: Theory and Experiment) at LaDisco (Center for Linguistics Research) and ULB Neuroscience Institute, Université libre de Bruxelles, Brussels, Belgium
| | - Inge-Marie Eigsti
- Department of Psychological Sciences, University of Connecticut, Storrs, Mansfield, Connecticut, United States of America
| | | | - Hirotaka Kosaka
- Department of Neuropsychiatry, University of Fukui, Fukui, Japan
| | - Rieko Osu
- Faculty of Human Sciences, Waseda University, Tokorozawa, Japan
| | - Yuko Okamoto
- Waseda Institue for Advanced Study, Waseda University, Tokyo, Japan
| | - Sophie Sowden
- School of Psychology, University of Birmingham, Birmingham, United Kingdom
| |
Collapse
|
8
|
Naslund JA, Deng D. Addressing Mental Health Stigma in Low-Income and Middle-Income Countries: A New Frontier for Digital Mental Health. ETHICS, MEDICINE, AND PUBLIC HEALTH 2021; 19:100719. [PMID: 35083375 PMCID: PMC8786211 DOI: 10.1016/j.jemep.2021.100719] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/27/2023]
Abstract
BACKGROUND Mental health stigma is a major barrier to seeking help, and leads to poor quality of life and social withdrawal for individuals living with mental illness. These concerns are especially severe in low-income and middle-income countries (LMICs) that face a disproportionate share of the global burden of mental illnesses. With growing access to digital technologies in LMICs, there may be new opportunities to address mental health stigma. This review considers the potential for emerging digital technologies to advance efforts to challenge mental health stigma in LMICs. METHODS Promising digital strategies to reduce mental health stigma were identified through searching the peer-reviewed literature. Drawing from the Mental Illness Stigma Framework, these studies of digital strategies were grouped into three categories: 1) protest; 2) education, and 3) contact. RESULTS These three categories align with established stigma reduction programs. Digital strategies could expand the reach of or complement existing efforts. There are challenges with digital stigma reduction strategies, including the need for cultural adaptation of these programs to diverse contexts and settings, consideration of reliable measurement of mental health related stigma, and risks that digital media could perpetuate the spread of misinformation and exacerbate concerns pertaining to mental health stigma. CONCLUSION This review highlights the promise of technology for addressing mental health stigma in LMICs. This is imperative in the face of growing demand for mental health services owing to the economic and social impacts of the COVID-19 pandemic, and the increasing reliance on digital platforms among individuals in most countries.
Collapse
Affiliation(s)
- John A. Naslund
- Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, USA
| | - Davy Deng
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| |
Collapse
|
9
|
Sunderaraman P, Irani F, Krishnan K, Hundal JS. A narrative review of the biopsychosocial and health characteristics of Asian Indians in the United States: Clinical and research implications for neuropsychological functioning. Clin Neuropsychol 2021:1-19. [PMID: 34818985 DOI: 10.1080/13854046.2021.1987524] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Objective: The prevailing scientific literature aggregates Asians living in America into one omnibus category and thus can problematically result in a subpar and at times inaccurate understanding of health, social and cultural factors necessary for competent and informed medical care. Method: A literature search was conducted by cultural experts familiar with Asian Indian culture with a focus on immigrants from this community living in the US. Database using search engines was sought in the following domains: immigration patterns, prevalence for key medical and neurological conditions commonly associated with cognitive dysfunction, psychiatric/psychological needs in the community, some preliminary neuropsychological testing considerations while working with this community, and treatment considerations that could affect adherence and efficacy of outcomes. Articles were selected from 2000 to the most recent date, with emphasis on compiling information from review papers and meta-analysis from the past decade. Conclusions: Asian Indians living in the US are distinct from the larger Asian American community. Immigration trends underscore that Asian Indians have a bimodal distribution of wealth. Regarding medical conditions, a key and highly concerning finding is the higher prevalence of cardiovascular risk factors, especially in young males. The lack of non-existent cognitive data in this community is glaring and should serve as an impetus for conducting high-priority research in this community. Preliminary neuropsychological testing considerations are discussed from a practical perspective with emphasis on multilingualism and region of origin. Finally, treatment considerations include understanding attitudes and beliefs regarding traditional medicine.
Collapse
Affiliation(s)
- Preeti Sunderaraman
- Cognitive Neuroscience Division of the Taub Institute for Research on Alzheimer's Disease and the Aging Brain, G.H.Sergeivsky Center, and the Department of Neurology, Columbia University Irving Medical Center, New York, NY, USA.,The Framingham Heart Study - Brain Aging Program, 73 Mount Wayte Avenue, Framingham, MA, USA
| | | | - Kamini Krishnan
- Lou Ruvo Center for Brain Health, Department of Neurology, Neurological Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Jasdeep S Hundal
- Department of Neurosurgery, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, USA
| |
Collapse
|
10
|
Aggarwal P, Raval VV, Chari U, Raman V, Kadnur Sreenivas K, Krishnamurthy S, Visweswariah AM. Clinicians' Perspectives on Diagnostic Markers for Depression Among Adolescents in India: An Embedded Mixed-Methods Study. Cult Med Psychiatry 2021; 45:163-192. [PMID: 32592142 DOI: 10.1007/s11013-020-09680-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Limited research has investigated whether clinicians around the world find diagnostic criteria for depression that were originally developed in the West are useful with diverse populations. Using an embedded mixed-methods design in India, we examined (a) clinicians' and trainees' (n = 143) ratings of the usefulness of the criteria for Major Depressive Disorder (MDD) outlined in two major diagnostic systems (Diagnostic and Statistical Manual of Mental Disorders-5; DSM-5 and International Classification of Mental and Behavioral Disorders-Tenth Edition; ICD-10), and (b) narrative descriptions of clinical cases of adolescent depression and usefulness of diagnostic and screening instruments in day-to-day practice using semi-structured interviews in a subsample of clinicians (n = 24). Qualitative findings demonstrated that Indian clinicians identified markers of depression that were consistent with the current diagnostic manuals (affective, cognitive, somatic symptoms), and the numeric ratings suggested that clinicians found a majority of DSM-5 and ICD-10 criteria for MDD to be useful. However, Indian clinicians also identified additional markers of adolescent depression (i.e., interpersonal conflicts and issues, impairment in school-related functioning, anger-based symptoms, anxiety-based symptoms, additional somatic complaints not included in DSM-5 or ICD-10), highlighting the need to modify existing diagnostic criteria to be more inclusive. The findings suggest the need for culturally informed diagnostic practices that consider a wide range of clinical presentations of depression among adolescents worldwide.
Collapse
Affiliation(s)
- Pankhuri Aggarwal
- Department of Psychology, Miami University, 90 N Patterson Ave, Oxford, OH, 45056, USA.
| | - Vaishali V Raval
- Department of Psychology, Miami University, 90 N Patterson Ave, Oxford, OH, 45056, USA
| | - Uttara Chari
- Department of Psychiatry, St. John's Medical College, Bengaluru, Karnataka, India
| | - Vijaya Raman
- Department of Psychiatry, St. John's Medical College, Bengaluru, Karnataka, India
| | | | | | | |
Collapse
|
11
|
Goodmann DR, Daouk S, Sullivan M, Cabrera J, Liu NH, Barakat S, Muñoz RF, Leykin Y. Factor analysis of depression symptoms across five broad cultural groups. J Affect Disord 2021; 282:227-235. [PMID: 33418371 DOI: 10.1016/j.jad.2020.12.159] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2020] [Revised: 11/24/2020] [Accepted: 12/24/2020] [Indexed: 01/07/2023]
Abstract
INTRODUCTION Core symptoms of depression are likely universal, however cultural groups differ in their experience of the condition. The purpose of this study was to examine differences and similarities of depression symptom groupings between broad cultural groups. METHOD 6,982 adults took part in an online multilingual depression screening study, and completed an 18-item major depression screener. Participants were categorized into five broad cultural groups by language and country of residence: Spanish speakers from Latin America (n = 3,411); English speakers from Southeast Asia (n = 1,265); Russian speakers from the former Soviet bloc (n = 642); English speakers from English-speaking Western countries (n = 999); and Chinese speakers from China (n = 665). Principal components analysis with promax rotation was used. RESULTS Both similarities and noteworthy differences in symptom clustering between groups were observed. For instance, though suicide-related items formed a separate cluster for most cultures, for the Latin-American group, worthlessness loaded with suicidality. Changes in appetite and changes in weight tended to load on different factors (except for Chinese and Russian groups). Hypersomnia tended to load with psychomotor agitation, and core depression symptoms tended to load with physical symptoms (except for the Russian group). LIMITATIONS Depression was assessed by a self-report measure aligned to DSM-IV. CONCLUSION The analysis contributes to a nuanced understanding of depression manifestations of various cultures, which may inform culturally sensitive clinical practice.
Collapse
Affiliation(s)
- Danielle R Goodmann
- Palo Alto University, 1791 Arastradero Rd, Palo Alto, CA 94304, United States
| | - Sariah Daouk
- Palo Alto University, 1791 Arastradero Rd, Palo Alto, CA 94304, United States
| | - Megan Sullivan
- Palo Alto University, 1791 Arastradero Rd, Palo Alto, CA 94304, United States
| | | | | | | | - Ricardo F Muñoz
- Palo Alto University, 1791 Arastradero Rd, Palo Alto, CA 94304, United States; University of California, San Francisco
| | - Yan Leykin
- Palo Alto University, 1791 Arastradero Rd, Palo Alto, CA 94304, United States; University of California, San Francisco.
| |
Collapse
|
12
|
Stigmatizing Beliefs About Depression in Diverse Ethnic Groups of Asian Americans. Community Ment Health J 2020; 56:79-87. [PMID: 31578672 DOI: 10.1007/s10597-019-00481-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2019] [Accepted: 09/25/2019] [Indexed: 10/25/2022]
Abstract
Focusing on diverse ethnic groups of Asian Americans, the present study examined the prevalence, ethnic variations, and predictors of stigmatizing beliefs about depression (beliefs that associate depression with a sign of weakness, shame to the whole family, and family disappointment, and beliefs that antidepressant medicines are addictive). Data were drawn from 2609 participants (age range 18-98) in the 2015 Asian American Quality of Life survey that includes Chinese, Asian Indian, Korean, Vietnamese, Filipinos, and other Asians. Results of a series of logistic models indicated that age, gender, ethnicity, length of stay in the U.S., English proficiency, and acculturation were significantly associated with stigmatizing beliefs about depression. Ethnic variations in beliefs were also observed. Implications for research and practice are discussed.
Collapse
|
13
|
Diagnostic Prevalence of Common Psychiatric Comorbidities of Alcohol Use Disorders in India: a Systematic Review. Int J Ment Health Addict 2018. [DOI: 10.1007/s11469-018-9951-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
|
14
|
Abstract
There is limited data on how community medical providers in India attempt to diagnose and treat depression, as well as on their general knowledge of and attitudes toward depression. A cross-sectional survey was conducted assessing knowledge and views of clinical depression with 80 non-psychiatric physicians and physician trainees recruited from community clinics and hospitals in Gujarat, India. Interviews were also held with 29 of the physicians to assess what they do in their own practices in regards to detection of and treatment of clinical depression. Although subjects showed a generally good basic understanding of the definition of clinical depression and its treatment, their responses reflected the presence of some negative and/or stigmatized attitudes toward clinical depression. Our findings raise the question of possible stigma among physicians themselves and underscore the importance of combatting physicians' stigma against and increasing awareness of how to detect and treat clinical depression.
Collapse
|
15
|
Morgado FFDR, Silveira EMKXD, Sales AM, Nascimento LPRD, Sarno EN, Nery JADC, Oliveira AJ, Illarramendi X. Cross-cultural adaptation of the EMIC Stigma Scale for people with leprosy in Brazil. Rev Saude Publica 2017; 51:80. [PMID: 28876410 PMCID: PMC5574468 DOI: 10.11606/s1518-8787.2017051000167] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2016] [Accepted: 09/13/2016] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE Describe the process of cross-cultural adaptation of the “Explanatory Model Interview Catalog – Stigma Scale” for people affected by leprosy in Brazil. METHODS After being authorized by the author of the scale to use it in the national context, we initiated the five steps process of cross-cultural adaptation: (1) translation, (2) synthesis meeting, (3) back-translation, (4) committee of experts and (5) pre-test. The internal consistency of the scale was evaluated using Cronbach’s alpha coefficient. RESULTS The 15 items of the scale’s original version were translated into Brazilian Portuguese. The adapted scale showed evidence of a good understanding of its content, attested both by experts and members of the target population. Its internal consistency was 0.64. CONCLUSIONS The adapted instrument shows satisfactory internal consistency. It may be useful in future studies that intend to provide broad situational analysis that supports solid public health programs with a focus on effective stigma reduction. In a later study, the construct’s validity, criterion, and reproducibility will be evaluated.
Collapse
Affiliation(s)
- Fabiane Frota da Rocha Morgado
- Instituto de Educação. Departamento de Educação Física e Desportos. Universidade Federal Rural do Rio de Janeiro. Seropédica, RJ, Brasil
| | | | - Anna Maria Sales
- Ambulatório Souza Araújo. Instituto Oswaldo Cruz. Rio de Janeiro, RJ, Brasil
| | | | - Euzenir Nunes Sarno
- Laboratório de Hanseníase. Instituto Oswaldo Cruz. Rio de Janeiro, RJ, Brasil
| | | | - Aldair J Oliveira
- Instituto de Educação. Departamento de Educação Física e Desportos. Universidade Federal Rural do Rio de Janeiro. Seropédica, RJ, Brasil
| | - Ximena Illarramendi
- Laboratório de Hanseníase. Instituto Oswaldo Cruz. Rio de Janeiro, RJ, Brasil.,Centro de Desenvolvimento Tecnológico em Saúde. Fundação Oswaldo Cruz. Rio de Janeiro, RJ, Brasil
| |
Collapse
|
16
|
Thapar-Olmos N, Myers HF. Stigmatizing attributions towards depression among South Asian and Caucasian college students. ACTA ACUST UNITED AC 2017. [DOI: 10.1080/17542863.2017.1340969] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
| | - Hector F. Myers
- Department of Psychology, University of California, Los Angeles, USA
| |
Collapse
|
17
|
Haroz EE, Ritchey M, Bass JK, Kohrt BA, Augustinavicius J, Michalopoulos L, Burkey MD, Bolton P. How is depression experienced around the world? A systematic review of qualitative literature. Soc Sci Med 2017; 183:151-162. [PMID: 28069271 PMCID: PMC5488686 DOI: 10.1016/j.socscimed.2016.12.030] [Citation(s) in RCA: 141] [Impact Index Per Article: 20.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2016] [Revised: 12/16/2016] [Accepted: 12/20/2016] [Indexed: 11/18/2022]
Abstract
To date global research on depression has used assessment tools based on research and clinical experience drawn from Western populations (i.e., in North American, European and Australian). There may be features of depression in non-Western populations which are not captured in current diagnostic criteria or measurement tools, as well as criteria for depression that are not relevant in other regions. We investigated this possibility through a systematic review of qualitative studies of depression worldwide. Nine online databases were searched for records that used qualitative methods to study depression. Initial searches were conducted between August 2012 and December 2012; an updated search was repeated in June of 2015 to include relevant literature published between December 30, 2012 and May 30, 2015. No date limits were set for inclusion of articles. A total of 16,130 records were identified and 138 met full inclusion criteria. Included studies were published between 1976 and 2015. These 138 studies represented data on 170 different study populations (some reported on multiple samples) and 77 different nationalities/ethnicities. Variation in results by geographical region, gender, and study context were examined to determine the consistency of descriptions across populations. Fisher's exact tests were used to compare frequencies of features across region, gender and context. Seven of the 15 features with the highest relative frequency form part of the DSM-5 diagnosis of Major Depressive Disorder (MDD). However, many of the other features with relatively high frequencies across the studies are associated features in the DSM, but are not prioritized as diagnostic criteria and therefore not included in standard instruments. The DSM-5 diagnostic criteria of problems with concentration and psychomotor agitation or slowing were infrequently mentioned. This research suggests that the DSM model and standard instruments currently based on the DSM may not adequately reflect the experience of depression at the worldwide or regional levels.
Collapse
Affiliation(s)
- E E Haroz
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, 624 N. Broadway, Baltimore, MD 21205, United States.
| | - M Ritchey
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, 733 N Broadway, Baltimore, MD 21205, United States
| | - J K Bass
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, 624 N. Broadway, Baltimore, MD 21205, United States
| | - B A Kohrt
- Duke University, Duke Global Health Institute & Department of Psychiatry and Behavioral Sciences, Durham, NC 27710, United States
| | - J Augustinavicius
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, 624 N. Broadway, Baltimore, MD 21205, United States
| | - L Michalopoulos
- School of Social Work, Columbia University, 1255 Amsterdam Avenue, New York, NY 10027, United States
| | - M D Burkey
- Department of Health, Behavior, and Society, Johns Hopkins Bloomberg School of Public Health, 624 N. Broadway, Baltimore, MD 21205, United States
| | - P Bolton
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, 624 N. Broadway, Baltimore, MD 21205, United States; Department of International Health, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe St., Baltimore, MD 21205, United States
| |
Collapse
|
18
|
Chandra RM, Arora L, Mehta UM, Asnaani A, Radhakrishnan R. Asian Indians in America: The influence of values and culture on mental health. Asian J Psychiatr 2016; 22:202-9. [PMID: 26442987 DOI: 10.1016/j.ajp.2015.09.011] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2015] [Revised: 09/18/2015] [Accepted: 09/19/2015] [Indexed: 11/30/2022]
Abstract
Asian Indians represent a significant portion of the largest growing race of Asians in the past decade in the United States. This selective review examines major cultural themes related to first- and second-generation Asian Indians living in the United States as they impact psychological and psychiatric dysfunction in this population. Specifically, we review the impact of Asian Indian culture on mental health, discuss the impact of acculturation and ethnic identity development on the mental health of Indian-Americans, and focus on typical mental health problems of Asian Indian adolescents, women and elderly in America. Finally, we provide a brief overview of empirically-supported treatment approaches and cultural considerations for additional treatments relevant to this population. This review is intended to provide an important foundation for more systematic empirically-driven investigation into better understanding how Asian Indian cultural themes impact mental health for Indian-Americans, and how to develop effective treatments for these issues in this cultural group.
Collapse
Affiliation(s)
| | - Lily Arora
- Rutgers University - New Jersey Medical School, Newark, NJ, United States
| | - Urvakhsh M Mehta
- Beth Israel Deaconess Medical Center, Boston, MA, United States; National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, India
| | - Anu Asnaani
- Department of Psychiatry, Center for the Treatment and Study of Anxiety, University of Pennsylvania, 3535 Market St, Suite 600 North, Philadelphia, PA 19104, United States.
| | | |
Collapse
|
19
|
Soni A, Fahey N, Byatt N, Prabhakaran A, Moore Simas TA, Vankar J, Phatak A, O'Keefe E, Allison J, Nimbalkar S. Association of common mental disorder symptoms with health and healthcare factors among women in rural western India: results of a cross-sectional survey. BMJ Open 2016; 6:e010834. [PMID: 27388353 PMCID: PMC4947826 DOI: 10.1136/bmjopen-2015-010834] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES Information about common mental disorders (CMD) is needed to guide policy and clinical interventions in low-income and middle-income countries. This study's purpose was to characterise the association of CMD symptoms with 3 inter-related health and healthcare factors among women from rural western India based on a representative, cross-sectional survey. SETTING Surveys were conducted in the waiting area of various outpatient clinics at a tertiary care hospital and in 16 rural villages in the Anand district of Gujarat, India. PARTICIPANTS 700 Gujarati-speaking women between the ages of 18-45 years who resided in the Anand district of Gujarat, India, were recruited in a quasi-randomised manner. PRIMARY AND SECONDARY OUTCOMES MEASURES CMD symptoms, ascertained using WHO's Self-Reporting Questionnaire-20 (SRQ-20), were associated with self-reported (1) number of healthcare visits in the prior year; (2) health status and (3) portion of yearly income expended on healthcare. RESULTS Data from 658 participants were used in this analysis; 19 surveys were excluded due to incompleteness, 18 surveys were excluded because the participants were visiting hospitalised patients and 5 surveys were classified as outliers. Overall, 155 (22·8%) participants screened positive for CMD symptoms (SRQ-20 score ≥8) with most (81.9%) not previously diagnosed despite contact with healthcare provider in the prior year. On adjusted analyses, screening positive for CMD symptoms was associated with worse category in self-reported health status (cumulative OR=9.39; 95% CI 5·97 to 14·76), higher portion of household income expended on healthcare (cumulative OR=2·31; 95% CL 1·52 to 3.52) and increased healthcare visits in the prior year (incidence rate ratio=1·24; 95% CI 1·07 to 1·44). CONCLUSIONS The high prevalence of potential CMD among women in rural India that is unrecognised and associated with adverse health and financial indicators highlights the individual and public health burden of CMD.
Collapse
Affiliation(s)
- Apurv Soni
- University of Massachusetts Medical School, Worcester, Massachusetts, USA
| | - Nisha Fahey
- University of Massachusetts Medical School, Worcester, Massachusetts, USA
- Des Moines University, Des Moines, Iowa, USA
| | - Nancy Byatt
- University of Massachusetts Medical School, Worcester, Massachusetts, USA
| | | | | | | | - Ajay Phatak
- Pramukhswami Medical College, Karamsad, Gujarat, India
| | | | - Jeroan Allison
- University of Massachusetts Medical School, Worcester, Massachusetts, USA
| | | |
Collapse
|
20
|
Amarasuriya SD, Jorm AF, Reavley NJ. Quantifying and predicting depression literacy of undergraduates: a cross sectional study in Sri Lanka. BMC Psychiatry 2015; 15:269. [PMID: 26518153 PMCID: PMC4628261 DOI: 10.1186/s12888-015-0658-8] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2015] [Accepted: 10/20/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The high rates of depression and low rates of related help-seeking among undergraduates are matters for concern. In response to the need to examine their knowledge about depression and its management, and the dearth of such research from non-western developing countries, this study examined the depression literacy of undergraduates in Sri Lanka. METHODS A questionnaire was administered among 4671 undergraduates to examine their depression literacy relating to problem-recognition, measured using a vignette of a depressed undergraduate, and their treatment beliefs measured by assessing their perceptions about the helpfulness of various options of help for the presented problem. Responses for the latter aspect were quantified using a scale comprising the options of help endorsed by Sri Lankan mental health professionals. Regression analysis models were used to identify the correlates of these aspects of depression literacy. RESULTS Females, medical undergraduates and those in higher years of study (compared to first-years) were more likely to recognise the problem as depression. The undergraduates obtained a mean percentage score of 76% on the constructed Depression Treatment Beliefs Scale. Scores on this scale were higher among females, medical undergraduates, those who got help for the problem after trying to deal with it alone and those who recognised the problem as depression, as well as those who used other mental health-related labels for this purpose. Scores were lower among undergraduates in years 2-4 (compared to first-years), those with family or friends with the problem and those with higher stigma on a Social Distance Scale. However, the effect sizes of these relationships were small. CONCLUSIONS As factors such as gender, discipline, year of study, exposure to depression and stigma are associated with differences in the depression literacy of these undergraduates, concerning their ability to recognise the problem and their related treatment beliefs, these must be considered when designing related educational initiatives. Recognising the problem as depression or the use of other mental health-related labels is associated with better treatment beliefs as per expert consensus, indicating that such labelling could have value for appropriate help-seeking.
Collapse
Affiliation(s)
- Santushi D. Amarasuriya
- Behavioural Sciences Stream, Faculty of Medicine, University of Colombo, 25, Kynsey Road, PO Box 271, Colombo 8 Colombo, Sri Lanka ,Centre for Mental Health, Melbourne School of Population and Global Health, University of Melbourne, 207 Bouverie Street, Parkville, Victoria 3010 Melbourne, Australia
| | - Anthony F. Jorm
- Centre for Mental Health, Melbourne School of Population and Global Health, University of Melbourne, 207 Bouverie Street, Parkville, Victoria 3010 Melbourne, Australia
| | - Nicola J. Reavley
- Centre for Mental Health, Melbourne School of Population and Global Health, University of Melbourne, 207 Bouverie Street, Parkville, Victoria 3010 Melbourne, Australia
| |
Collapse
|
21
|
Amarasuriya SD, Jorm AF, Reavley NJ. Depression literacy of undergraduates in a non-western developing context: the case of Sri Lanka. BMC Res Notes 2015; 8:593. [PMID: 26493708 PMCID: PMC4619076 DOI: 10.1186/s13104-015-1589-7] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2015] [Accepted: 10/14/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Research examining the depression literacy of undergraduates in non-western developing countries is limited. This study explores this among undergraduates in Sri Lanka. METHODS A total of 4671 undergraduates responded to a survey presenting a vignette of a depressed undergraduate. They were asked to identify the problem, describe their intended help-seeking actions if affected by it and rate the helpfulness of a range of help-providers and interventions for dealing with it. Mental health experts also rated these options, providing a benchmark for assessing the undergraduates' responses. RESULTS Only 17.4% of undergraduates recognised depression, but this was significantly lower among those responding in Sinhala compared to English (3.5 vs 36.8%). More undergraduates indicated intentions of seeking informal help, such as from friends and parents, than from professionals, such as psychiatrists and counsellors. However, a majority rated all these help-providers as 'helpful', aligning with expert opinion. Other options recommended by experts and rated as 'helpful' by a large proportion of undergraduates included counselling/psychological therapy and self-help strategies such as doing enjoyable activities and meditation/yoga/relaxation exercises. However, a low proportion of undergraduates rated "western medicine to improve mood" as 'helpful', deviating from expert opinion. Although not endorsed by experts, undergraduates indicated intentions of using religious strategies, highly endorsing these as 'helpful'. Labelling the problem as depression and using mental health-related labels were both associated with higher odds of endorsing professional help, with the label 'depression' associated with endorsing a wider range of professional options. CONCLUSIONS The recognition rate of depression might be associated with the language used to label it. These undergraduates' knowledge about the use of medication for depression needs improvement. Health promotion interventions for depressed undergraduates must be designed in light of the prevalent socio-cultural backdrop, such as the undergraduates' high endorsement of informal and culturally relevant help-seeking. Improving their ability to recognise the problem as being mental health-related might trigger their use of professional options of help.
Collapse
Affiliation(s)
- Santushi D Amarasuriya
- Behavioural Sciences Stream, Faculty of Medicine, University of Colombo, 25, Kynsey Road, PO Box 271, Colombo 8, Sri Lanka. .,Centre for Mental Health, Melbourne School of Population and Global Health, University of Melbourne, 207 Bouverie Street, Parkville, VIC, 3010, Australia.
| | - Anthony F Jorm
- Centre for Mental Health, Melbourne School of Population and Global Health, University of Melbourne, 207 Bouverie Street, Parkville, VIC, 3010, Australia.
| | - Nicola J Reavley
- Centre for Mental Health, Melbourne School of Population and Global Health, University of Melbourne, 207 Bouverie Street, Parkville, VIC, 3010, Australia.
| |
Collapse
|
22
|
Amarasuriya SD, Jorm AF, Reavley NJ, Mackinnon AJ. Stigmatising attitudes of undergraduates towards their peers with depression: a cross-sectional study in Sri Lanka. BMC Psychiatry 2015; 15:129. [PMID: 26087847 PMCID: PMC4472246 DOI: 10.1186/s12888-015-0523-9] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2014] [Accepted: 06/09/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND There is limited research examining mental health-related stigma of undergraduates in non-western developing countries. This study examined stigma of undergraduates in Sri Lanka towards another depressed undergraduate. METHODS A hypothetical vignette of an undergraduate suffering from depression was presented. A total of 4650 undergraduates responded to scales assessing their personal stigma towards and desire for social distance from this individual. Exploratory structural equation modelling (ESEM) was performed to determine the dimensionality and loading pattern of the items on these two stigma scales. Multiple linear regressions were used to explore correlates of the identified dimensions of stigma. RESULTS Previous findings that the Social Distance Scale forms a single dimension and that the Personal Stigma Scale consists of two dimensions were supported. However, the measurement structure of the dimensions of stigma on the latter scales, labelled 'Weak-not-Sick' and 'Dangerous-Undesirable' , differed from previous work. A high level of stigma in relation to the 'Weak-not-Sick' Scale was observed. However, some correlates associated with lower levels of stigma on this scale, such as being in the Medical Faculty, were associated with higher levels of stigma on the 'Dangerous-Undesirable' and 'Social Distance' scales. In contrast, labelling the problem as a mental health-related problem, with absence of specific psychiatric terminology, was associated with lower levels of stigma on these latter two scales. Exposure to a mental health problem in family or friends or from personal experience was also associated with lower stigma on the Social Distance Scale. However, the effect sizes of these relationships were small. CONCLUSIONS The findings highlight differences in the measurement structure and score distribution of the 'Weak-not-Sick' and 'Dangerous-Undesirable' scales when used in different cultural and demographic contexts. The dimensionality of stigma relevant to these scales must always be established prior to their use in different contexts. Furthermore, campaigns targeted at improving knowledge about depression as a real illness and as a psychiatric condition need to ensure that such attempts are not associated with increases in other aspects of stigma.
Collapse
Affiliation(s)
- Santushi D. Amarasuriya
- Behavioural Sciences Stream, Faculty of Medicine, University of Colombo, No. 25, PO Box 271, Kynsey Road, Colombo 8, Sri Lanka ,Centre for Mental Health, Melbourne School of Population and Global Health, 207 Bouverie Street, University of Melbourne, Melbourne, VIC 3010 Australia
| | - Anthony F. Jorm
- Centre for Mental Health, Melbourne School of Population and Global Health, 207 Bouverie Street, University of Melbourne, Melbourne, VIC 3010 Australia
| | - Nicola J. Reavley
- Centre for Mental Health, Melbourne School of Population and Global Health, 207 Bouverie Street, University of Melbourne, Melbourne, VIC 3010 Australia
| | - Andrew J. Mackinnon
- Orygen, The National Centre of Excellence in Youth Mental Health, University of Melbourne, Parkville VIC 3052 Melbourne, Australia
| |
Collapse
|
23
|
Hagmayer Y, Engelmann N. Causal beliefs about depression in different cultural groups-what do cognitive psychological theories of causal learning and reasoning predict? Front Psychol 2014; 5:1303. [PMID: 25505432 PMCID: PMC4243491 DOI: 10.3389/fpsyg.2014.01303] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2014] [Accepted: 10/27/2014] [Indexed: 11/14/2022] Open
Abstract
Cognitive psychological research focuses on causal learning and reasoning while cognitive anthropological and social science research tend to focus on systems of beliefs. Our aim was to explore how these two types of research can inform each other. Cognitive psychological theories (causal model theory and causal Bayes nets) were used to derive predictions for systems of causal beliefs. These predictions were then applied to lay theories of depression as a specific test case. A systematic literature review on causal beliefs about depression was conducted, including original, quantitative research. Thirty-six studies investigating 13 non-Western and 32 Western cultural groups were analyzed by classifying assumed causes and preferred forms of treatment into common categories. Relations between beliefs and treatment preferences were assessed. Substantial agreement between cultural groups was found with respect to the impact of observable causes. Stress was generally rated as most important. Less agreement resulted for hidden, especially supernatural causes. Causal beliefs were clearly related to treatment preferences in Western groups, while evidence was mostly lacking for non-Western groups. Overall predictions were supported, but there were considerable methodological limitations. Pointers to future research, which may combine studies on causal beliefs with experimental paradigms on causal reasoning, are given.
Collapse
Affiliation(s)
- York Hagmayer
- Institute of Psychology, University of GoettingenGoettingen, Germany
| | | |
Collapse
|
24
|
Abstract
Limited data exist regarding community attitudes and knowledge about clinical depression in rural India. We administered 159 questionnaires and 7 focus groups to Gujarati villagers to explore knowledge and beliefs about clinical depression. Quantitative data were analyzed for frequencies, nonparametric correlations, and principal components, whereas qualitative data were coded for prominent themes. Two groups of subjects emerged from our analysis: one "medically oriented" group that viewed depression as a medical condition and expressed optimism regarding its prognosis and one "spiritually oriented" group that expressed pessimism. Correlations emerged between etiological belief, degree of optimism, and associated stigma. The subjects were pessimistic when they attributed depression to a traumatic event, punishment from God, or brain disease but optimistic when depression was attributed to socioeconomic circumstances. Overall, the subjects were knowledgeable and open-minded toward depression and demonstrated curiosity and willingness to learn more. This study will help to inform future clinical and educational outreach in rural Gujarat.
Collapse
|
25
|
Kulesza M, Raguram R, Rao D. Perceived mental health related stigma, gender, and depressive symptom severity in a psychiatric facility in South India. Asian J Psychiatr 2014; 9:73-7. [PMID: 24813041 DOI: 10.1016/j.ajp.2014.03.005] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2013] [Revised: 03/04/2014] [Accepted: 03/08/2014] [Indexed: 11/18/2022]
Abstract
BACKGROUND Few studies exist on the topic of gender associated with depression and mental health-related stigma coming out of non-Western countries such as India. We aimed to add to the literature by assessing these relationships among adults seeking psychiatric services in India. METHODS Participants were 60 individuals seeking care at a psychiatric clinic in Bangalore, India. The majority of participants were female with a mean age of 36 years (SD=9.75). RESULTS Contrary to our prediction, there were no significant differences between men (M=28.96; SD=9.85) and women (M=33.03; SD=12.08) on depression severity, t(58)=1.42, p=.16. Yet, women (M=10.09, SD=8.23) reported significantly more perceived stigma than men (M=5.79, SD=5.86), t(58)=2.30, p=.02. CONCLUSION While men and women seeking psychiatric services at the psychiatric clinic in India report similar levels of depression severity, women reported more perceived mental illness stigma. Having experienced regular forms of discrimination associated with female status in India, it may be the case that women are more attuned to other forms of stigma, such as mental health stigma investigated in the present study. Given the detrimental impact of stigma on treatment adherence and engagement in care, additional research is needed support this work, including research on interventions to reduce stigma and improve engagement in care.
Collapse
Affiliation(s)
- Magdalena Kulesza
- Department of Psychiatry and Behavioral Sciences, Center for Study of Health and Risk Behaviors, University of Washington, 1100 NE 45th Street, Suite 300, Seattle, WA 98105, United States.
| | - R Raguram
- Department of Psychiatry, Kempegowda Institute of Medical Sciences, Bangalore, India
| | - Deepa Rao
- Department of Global Health, University of Washington, 325 9th Avenue, Seattle, WA 98104, United States
| |
Collapse
|
26
|
Perceived Stigma and Associated Factors among People with Schizophrenia at Amanuel Mental Specialized Hospital, Addis Ababa, Ethiopia: A Cross-Sectional Institution Based Study. PSYCHIATRY JOURNAL 2014; 2014:694565. [PMID: 24967300 PMCID: PMC4055492 DOI: 10.1155/2014/694565] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/18/2014] [Revised: 04/23/2014] [Accepted: 05/07/2014] [Indexed: 12/26/2022]
Abstract
Background. While effective treatments are available for people with schizophrenia, presence of perceived stigma prevents them from accessing and receiving the help they need to get. Objectives. To assess the prevalence and associated factors of perceived stigma among people with schizophrenia attending the Outpatient Department of Amanuel Mental Specialized Hospital, Addis Ababa, Ethiopia. Methods. Institution based cross-sectional study design was conducted among 411 subjects using an Amharic version of the perceived devaluation and discrimination scale. Single population proportion formula was used to calculate sample size. Subjects were selected by systematic sampling techniques. Binary logistic regression and odds ratio with 95% confidence interval were used to identify the association factors of outcome variables. Results. A total of 411 subjects participated in the study giving a response rate of 97.4%. The prevalence of perceived stigma was found to be 83.5%. Education status (not able to read and write) (AOR = 2.64, 95% CI: 1.118, 6.227), difficulties of adherence to antipsychotic drug (AOR = 4.49, 95% CI: 2.309, 8.732), and duration of illness less than one year (AOR = 3.48, 95% CI: 2.238, 5.422) were factors associated with perceived stigma. Conclusion. Overall, the prevalence of perceived stigma was found to be high. Education status (not able to read and write), difficulties of adherence to antipsychotic medication, and duration of illness were factors associated with perceived stigma. Adherence to antipsychotic medication particularly during the early stage of the illness and strengthening the educational status of the participants were suggested in the clinical care setting.
Collapse
|
27
|
Abstract
OBJECTIVE The lifetime diagnosis of substance dependence syndrome is a major risk factor for attempting suicide. The systematic study of various risk factors of suicide in substance-dependent patients in Indian population will have far-reaching implications about the understanding of disorder. The objective was to study the sociodemographic and clinical factors associated with deliberate self-harm (DSH) in nondepressed substance-dependent patients. METHODS Participants included 60 male inpatients (30 patients with DSH and 30 without DSH) fulfilling International Classification of Diseases, Tenth Revision Diagnostic Criteria for Research for substance dependence syndrome, aged between 18 and 60 years, with Hamilton Depression Rating Scale score fewer than 7. They were assessed using Addiction Severity Index, Presumptive Stressful Life Event Scale, State-Trait Anger Expression Inventory, Lubben Social Network Scale, International Personality Disorder Examination, Risk Rescue Rating Scale, and Global Assessment of Functioning. RESULT Patients with DSH had significantly higher rates of opioid dependence (P < .05), risk of isolation (P < 0.001), the number of life events (P < 0.001), anger trait and anger expression (P < 0.001), personality disorder (P < 0.05), the number of substance use problems and lower social functioning (P < 0.001), as compared with those without DSH (P < 0.001). There was no significant correlation between Risk Rescue Rating Scale with sociodemographic and clinical variables. CONCLUSIONS The study demonstrated that patients with opioid dependence, high risk of isolation, the greater number of life events, higher anger trait and anger expression, personality disorder, low social functioning, and greater number of substance use problems have risk for DSH.
Collapse
|