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Wentholt WGM, Janssen LHC, van Houtum LAEM, Wever MCM, Tollenaar MS, Alink LRA, Elzinga BM. A qualitative, multi-perspective study on causal beliefs about adolescent depression. Psychol Psychother 2024. [PMID: 38780187 DOI: 10.1111/papt.12528] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Revised: 02/16/2024] [Accepted: 04/26/2024] [Indexed: 05/25/2024]
Abstract
OBJECTIVES The current study aimed to examine: (1.1) causal beliefs about adolescent depression in a sample of adolescents with a clinical depression and their mothers and fathers; (1.2) within-family overlap of causal beliefs; (2.1) mothers' and fathers' reflected causal beliefs about their child's perspective; (2.2) the accuracy of mothers' and fathers' reflected causal beliefs as related to their child's causal beliefs. DESIGN Qualitative study using a within-family approach. METHODS Adolescents with a current clinical depression (MDD/dysthymia; N = 34) and their parents (N = 34 mothers, N = 26 fathers) were independently interviewed about their causal beliefs about the adolescents' depression. Parents were additionally interviewed about their perception of their child's causal beliefs (i.e., reflected causal beliefs). RESULTS The causal beliefs most frequently mentioned by adolescents, mothers and fathers are: characteristics of the child, social factors, school and various stressful experiences. Parent-child overlap was relatively low, specifically for the themes of bewilderment, cumulative effect and stressful life events, whereas overlap was relatively high for themes of social factors, school and stressful experiences outside of the family. Parents were relatively accurate in their reflected causal beliefs, but tended to underestimate their child's insights into possible causes of their depression. Accuracy of parents' reflected causal beliefs was particularly low for the theme cumulative effect and high for social factors. CONCLUSIONS The various causal beliefs of adolescents and their parents could be used in therapeutic setting. Future research could examine whether (guided) conversations may promote alignment within families and treatment efficacy.
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Affiliation(s)
- Wilma G M Wentholt
- Department of Clinical Psychology, Leiden University, Leiden, The Netherlands
- Leiden Institute for Brain and Cognition, Leiden, The Netherlands
| | - Loes H C Janssen
- Department of Clinical Psychology, Leiden University, Leiden, The Netherlands
- Leiden Institute for Brain and Cognition, Leiden, The Netherlands
| | - Lisanne A E M van Houtum
- Department of Clinical Psychology, Leiden University, Leiden, The Netherlands
- Leiden Institute for Brain and Cognition, Leiden, The Netherlands
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC, University Medical Centre Rotterdam - Sophia, Rotterdam, The Netherlands
| | - Mirjam C M Wever
- Department of Clinical Psychology, Leiden University, Leiden, The Netherlands
- Leiden Institute for Brain and Cognition, Leiden, The Netherlands
| | - Marieke S Tollenaar
- Department of Clinical Psychology, Leiden University, Leiden, The Netherlands
- Leiden Institute for Brain and Cognition, Leiden, The Netherlands
| | - Lenneke R A Alink
- Institute of Education and Child Studies, Leiden University, Leiden, The Netherlands
| | - Bernet M Elzinga
- Department of Clinical Psychology, Leiden University, Leiden, The Netherlands
- Leiden Institute for Brain and Cognition, Leiden, The Netherlands
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Ahuvia IL, Sotomayor I, Kwong K, Lam FW, Mirza A, Schleider JL. Causal beliefs about mental illness: A scoping review. Soc Sci Med 2024; 345:116670. [PMID: 38402842 DOI: 10.1016/j.socscimed.2024.116670] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Revised: 11/02/2023] [Accepted: 02/07/2024] [Indexed: 02/27/2024]
Abstract
Research on causal beliefs about mental illness-the beliefs people hold about what causes a particular mental illness, or mental illnesses in general-is split across a number of theories and disciplines. Although research on this subject has provided a number of insights and practical applications, the diversity of theories, terminology, and keywords makes it challenging for a new reader to gain a comprehensive understanding. We sought to address this by conducting a systematic scoping review of research on causal beliefs. This review included English-language articles from any year that mentioned causal beliefs for mental illness in their title or abstract. We identified articles in two stages. In the first stage, we used a narrow set of search terms referring specifically to causal beliefs (1227 records identified, 417 included). In the second stage, we used a comprehensive set of terms relevant to research on causal beliefs (10,418 records identified, 3838 included). We analyzed articles qualitatively, organizing them into one of five theories or categories: the common-sense model of self-regulation, explanatory models, mental health literacy, biogenetic causal beliefs, and other research on causal beliefs. We provide a comprehensive summary of these literatures in terms of their history, typical research questions and study design, findings, and practical applications. These theories differ in their theoretical orientation towards causal beliefs, research methods, findings, and applications. However, they broadly share a view of causal beliefs as multifaceted, culturally determined, and relevant for additional psychosocial variables such as mental illness stigma and help-seeking. We conclude by making recommendations for researchers, clinicians, public health messaging, and for individuals with mental illness.
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Affiliation(s)
- Isaac L Ahuvia
- Stony Brook University, Department of Psychology Stony Brook University, Stony Brook, NY, 11794-2500, USA.
| | - Ian Sotomayor
- Stony Brook University, Department of Psychology Stony Brook University, Stony Brook, NY, 11794-2500, USA
| | - Kelly Kwong
- Stony Brook University, Department of Psychology Stony Brook University, Stony Brook, NY, 11794-2500, USA
| | - Fiona W Lam
- Stony Brook University, Department of Psychology Stony Brook University, Stony Brook, NY, 11794-2500, USA
| | - Aqsa Mirza
- New York University Steinhardt School of Culture, Education, and Human Development 246 Greene St. New York, NY 10003, USA
| | - Jessica L Schleider
- Northwestern University Feinberg School of Medicine Department of Medical Social Sciences, 625 N. Michigan Ave., 21st Floor, Chicago, IL, 60611, USA
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Lavdas M, Guribye E, Sandal GM. "Of course, you get depression in this situation": Explanatory Models (EMs) among Afghan refugees in camps in Northern Greece. BMC Psychiatry 2023; 23:125. [PMID: 36843000 PMCID: PMC9968643 DOI: 10.1186/s12888-023-04613-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Accepted: 02/16/2023] [Indexed: 02/28/2023] Open
Abstract
BACKGROUND Afghan refugees and asylum seekers constitute one of the largest groups that live in camp settings in Greece. While they experience psychological distress, they are facing significant barriers in accessing appropriate mental health care. Explanatory Models (EMs) provide a context-sensitive framework for understanding the differences between health professionals, refugees and NGOs that operate on the field. This study aims at further understanding how Afghan refugees perceive and explain depression and largely psychological distress, and how this influences their choices for coping strategies and help-seeking. METHODS This qualitative study included six vignette-based semi-structured focus-group discussions with Afghan refugees and asylum-seekers (total N = 19, 12 female and 7 male) residing largely in camp settings in Northern Greece. The vignette describes a fictional person with symptoms of depression in line with DSM-5 and ICD-10 criteria. The interviews were recorded, transcribed, and analysed through template analysis. RESULTS EMs for depression are explained through Pre-migration Traumatic Experiences (PMTE) and Post-migration Living Difficulties (PMLD) relating to camp settings. Female participants identified gender-based and domestic violence as contributing to psychological distress while males highlighted conflict and persecution. Life in the camp with associated inactivity, and uncertainty for the future, was perceived as a significant risk factor for psychological distress among females and males. In terms of coping strategies, females tended to focus on mobilizing collective resources within the camp (e.g. safe space for women facilitating emotional support), while males advocated for self-empowerment and solution-oriented coping. The value of engagement in peer helper-roles was highlighted. CONCLUSIONS The results highlight the potential value of community-based psychosocial approaches to support and promote mental health within camp settings. Additionally, they may inform policies and practices regarding access to appropriate mental health care for Afghan refugees. Further research is needed to establish the efficiency of such interventions in this context.
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Affiliation(s)
- Michalis Lavdas
- Department of Psychosocial Science, Faculty of Psychology, University of Bergen, Bergen, Norway.
| | - Eugene Guribye
- grid.509009.5NORCE Norwegian Research Centre, Kristiansand, Norway
| | - Gro Mjeldheim Sandal
- grid.7914.b0000 0004 1936 7443Department of Psychosocial Science, Faculty of Psychology, University of Bergen, Bergen, Norway
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Khan N. The serotonin theory of depression and why we use antidepressants. Br J Gen Pract 2022; 72:536-537. [PMID: 36302678 PMCID: PMC9591074 DOI: 10.3399/bjgp22x721109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Affiliation(s)
- Nada Khan
- Nada is an Exeter-based National Institute for Health and Care Research Academic Clinical Fellow in general practice, GPST4/Registrar, and an Associate Editor at the BJGP. @nadafkhan
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Knettel BA, Cherenack EM, Friis EA. Examining causal attributions for depression, alcohol use disorder, and schizophrenia in a diverse sample of international students at U.S. universities. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2022; 70:2176-2183. [PMID: 33400636 DOI: 10.1080/07448481.2020.1846046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/09/2020] [Revised: 10/26/2020] [Accepted: 10/30/2020] [Indexed: 06/12/2023]
Abstract
ObjectivesInternational students face increased vulnerability for mental health challenges, but underutilize counseling compared to their domestic peers. We examined beliefs regarding the causes of mental illness, known as attributions, which may impact treatment-seeking and stigma. Participants: Surveys were collected from 680 international students at U.S. universities. Methods: We sent invitations to a computer-based survey disseminated via international student email lists. The survey explored mental health attributions for depression, alcohol use disorder, and schizophrenia. Results: Attributions differed significantly by disorder. Depression and alcohol use were attributed to social stress and perceived as controllable and influenced by personal weakness and lifestyle choices. Schizophrenia was often attributed to hereditary/biological causes. Differences also emerged based on the participants' acculturation, region of origin, and religiosity. Conclusions: Attributions influence perceptions of mental illness and may lead to stigma. Providers should incorporate discussions of attribution in student outreach and counseling to address potential impacts on care-seeking.
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Affiliation(s)
- Brandon A Knettel
- School of Nursing, Duke University, Durham, North Carolina, USA
- Duke Global Health Institute, Duke University, Durham, North Carolina, USA
- College of Education, Lehigh University, Bethlehem, Pennsylvania, USA
| | - Emily M Cherenack
- Duke Global Health Institute, Duke University, Durham, North Carolina, USA
- Department of Psychology and Neuroscience, Duke University, Durham, North Carolina, USA
| | - Elsa A Friis
- Duke Global Health Institute, Duke University, Durham, North Carolina, USA
- Department of Psychology and Neuroscience, Duke University, Durham, North Carolina, USA
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Camacho-Leon G, Faytong-Haro M, Carrera K, De la Hoz I, Araujo-Contreras R, Roa K, Mautong H, Cardozo J, Briceño M, Cherrez-Ojeda I. Attitudes towards depression of Argentinian, Chilean, and Venezuelan healthcare professionals using the Spanish validated version of the revised depression attitude questionnaire (SR-DAQ). SSM Popul Health 2022; 19:101180. [PMID: 35968042 PMCID: PMC9365952 DOI: 10.1016/j.ssmph.2022.101180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Revised: 06/26/2022] [Accepted: 07/19/2022] [Indexed: 11/25/2022] Open
Abstract
Background The beliefs and attitudes of physicians toward depression may predict whether they are supportive or avoidant of patients diagnosed with this condition. Describing the attitudes toward depression of Argentinian, Chilean, and Venezuelan healthcare professionals could be a valuable tool for understanding the Latin American perspective on depression recognition, management, and prevention. Materials and methods A cross-sectional study was conducted among healthcare professionals in Argentina, Chile, and Venezuela using the Spanish validated version of the revised depression attitude questionnaire (R-DAQ). The questionnaire was collected online from August to November 2021, in a quota-based sample of 1759 health professionals (the final analytical sample is 1234). Descriptive data analyses were performed using STATA version 16 statistical software. Results Depression was considered a disease that anyone could suffer by 90% of the respondents. However, 70% of professionals answered that they feel more comfortable dealing with physical illness than mental illness. Furthermore, the findings show that a quarter of the participants in the study believed that either medical treatment (28.6%) or psychosocial approach (<20%) were ineffective tools for people suffering from depression. Findings also show that depression is seen as a more natural part of life by Argentinian professionals and men. Finally, psychologists and psychiatrists are most likely to treat depression as any other physical disease. Medical providers who routinely perform surgeries are not as likely to know how to treat depression or consider it an actual disease. Conclusions Healthcare professionals in Argentina, Chile, and Venezuela have varying attitudes toward depression. While they recognize depression as a disease on the same level as other physical diseases, most do not know how to treat it. The findings point to the need for these countries to promote the training of healthcare workers in areas such as depression diagnosis, treatment, and social interventions. Physicians' attitudes toward patients who exhibit signs and symptoms of depression can impact the disease's outcomes. This study offers a basis for understanding Latin American physicians' expertise and confidence in depression care. Our data revealed that less than half of respondents in all three countries received depression management training. Our findings show that less than half of respondents believe they are prepared to assess depression in patients. This study emphasizes the need of training and preparing healthcare personnel to have improved attitudes toward depression.
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Affiliation(s)
- Genesis Camacho-Leon
- División de Estudios para Graduados, Facultad de Medicina, Universidad del Zulia. Maracaibo, 4001, Venezuela.,Division of Clinical and Translational Research, Larkin Community Hospital, South Miami, FL, USA
| | - Marco Faytong-Haro
- Ecuadorian Development Research Lab, Daule, 090656, Ecuador.,Sociology and Demography Department, The Pennsylvania State University, University Park, PA, USA
| | | | - Ivonne De la Hoz
- División de Estudios para Graduados, Facultad de Medicina, Universidad del Zulia. Maracaibo, 4001, Venezuela
| | | | - Karelis Roa
- Médicos Unidos Por Venezuela, Caracas, 1080, Venezuela
| | - Hans Mautong
- Universidad de Especialidades Espíritu Santo, Samborondón, 0901952, Ecuador.,Respiralab Research Group, Guayaquil, 090501, Ecuador
| | | | | | - Ivan Cherrez-Ojeda
- Universidad de Especialidades Espíritu Santo, Samborondón, 0901952, Ecuador.,Respiralab Research Group, Guayaquil, 090501, Ecuador
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7
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Abstract
The dominant view within mental health services and research suggests that feeling depressed is a kind of medical illness, partially caused by various biological deficits which are somehow corrected by physical interventions. This article critically appraises evidence for the effectiveness and value of antidepressant drugs and electroconvulsive therapy (ECT), the two principle physical treatments recommended for depression. It also describes the negative effects of these interventions and raises concerns about how they impact the brain. We propose an alternative understanding that recognises depression as an emotional and meaningful response to unwanted life events and circumstances. This perspective demands that we address the social conditions that make depression likely and suggests that a combination of politics and common sense needs to guide us in providing help for one another when we are suffering in this way. This alternative view is increasingly endorsed around the world, including by the United Nations, the World Health Organization and service users who have suffered negative consequences of physical treatments that modify brain functions in ways that are not well-understood.
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Affiliation(s)
- John Read
- School of Psychology, University of East London, London E15 4LZ, UK
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8
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Lay beliefs about the causes and treatment of depression: Tests of measurement models and associations. J Affect Disord 2022; 299:93-101. [PMID: 34808135 DOI: 10.1016/j.jad.2021.11.052] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Revised: 10/01/2021] [Accepted: 11/16/2021] [Indexed: 11/21/2022]
Abstract
BACKGROUND There is reason to expect beliefs about depression's causes and treatment to influence use of psychotherapy, but the literature is marked by theoretical, methodological, and empirical inconsistencies. This study assessed the factorial validity of measures of beliefs about depression's causes and formal treatment versus self-management. It also tested the links of causal attributions to general treatment/self-management beliefs and endorsement of specific interventions. METHODS The revised Illness Perception Questionnaire (IPQ-R) adapted for depression was administered online to a non-patient, U.S. sample (N = 319). RESULTS Confirmatory factor analyses yielded three causal dimensions, Environmental Stressors, Biological Factors, and Personal Attributes, and two control dimensions, (Formal) Treatment and Personal. Both models fit irrespective of whether respondents believed they had ever experienced depression. A structural equation model (SEM) showed a positive relationship for Environmental and Biological attributions, and an inverse relationship for Personal attributions, in predicting general preferences for Formal Treatment. A second SEM, focusing on specific interventions, linked Environmental causation to endorsement of psychotherapy, dietary changes, and self-help, and Biological causation to endorsement of medication and exercise, with Personal causation inversely associated with endorsement of psychotherapy. LIMITATIONS A cross-sectional, correlational design precludes causal inferences. Potential sociocultural influences were not assessed. CONCLUSIONS Modifications to the IPQ-R suggested by this study improved its psychometric properties, validated its distinction between Treatment and Personal Control beliefs, and supported examination of both general and specific beliefs about ways to deal with depression. Relationships linking cause and treatment beliefs warrant further investigation as potential intervention targets to increase treatment utilization.
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9
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Serial indirect effects of psychosocial causal beliefs and stigma on help-seeking preferences for depression. CURRENT PSYCHOLOGY 2022. [DOI: 10.1007/s12144-021-02683-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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10
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Brea Larios D, Sandal GM, Guribye E, Markova V, Sam DL. Explanatory models of post-traumatic stress disorder (PTSD) and depression among Afghan refugees in Norway. BMC Psychol 2022; 10:5. [PMID: 34983663 PMCID: PMC8728976 DOI: 10.1186/s40359-021-00709-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2021] [Accepted: 12/20/2021] [Indexed: 11/04/2022] Open
Abstract
Background The current situation in Afghanistan makes it likely that we are facing a new wave of Afghan refugees, warranting more knowledge about how to deal with mental health problems among them. This study aims to gain more knowledge on Explanatory Models (EM) of depression and post-traumatic stress disorders (PTSD) among Afghan refugees resettled in Norway.
Methods We conducted six gender-separated, semi-structured focusgroup interviews based on vignettes with Afghan refugees (total N = 27). The vignettes described a fictional character with symptoms of either depression or PTSD symptoms in line with DSM-5 and ICD-10 criteria.
Results The findings showed that EM varied with gender, age, generation, and migration stories. Participants suggested different potential causes, risk factors, and ways of managing symptoms of depression and PTSD depending on the context (e.g., in Norway vs. Afghanistan). In describing the causes of the depression/PTSD in the vignettes, females tended to emphasize domestic problems and gender issues while males focused more on acculturation challenges. The younger males discussed mostly traumatic experiences before and during flight as possible causes. Conclusion The practice of condensing a single set of EMs within a group may not only be analytically challenging in a time-pressed clinical setting but also misleading. Rather, we advocate asking empathic questions and roughly mapping individual refugee patients’ perceptions on causes and treatment as a better starting point for building trusting relationships and inviting patients to share and put into practice their expertise about their own lives. Supplementary Information The online version contains supplementary material available at 10.1186/s40359-021-00709-0.
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Affiliation(s)
- Dixie Brea Larios
- Department of Psychosocial Science, University of Bergen, Christies Gate 12, Postboks 7807, 5015, Bergen, Norway.
| | - Gro Mjeldheim Sandal
- Department of Psychosocial Science, University of Bergen, Christies Gate 12, Postboks 7807, 5015, Bergen, Norway
| | | | - Valeria Markova
- Department of Pulmonology, Haukeland University Hospital, Bergen, Norway
| | - David Lackland Sam
- Department of Psychosocial Science, University of Bergen, Christies Gate 12, Postboks 7807, 5015, Bergen, Norway
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11
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Aarethun V, Sandal GM, Guribye E, Markova V, Bye HH. Explanatory models and help-seeking for symptoms of PTSD and depression among Syrian refugees. Soc Sci Med 2021; 277:113889. [PMID: 33838449 DOI: 10.1016/j.socscimed.2021.113889] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 03/18/2021] [Accepted: 03/27/2021] [Indexed: 10/21/2022]
Abstract
OBJECTIVE This study investigates how Syrian refugees explain and prefer to seek help for symptoms of post-traumatic stress disorder (PTSD) and depression. METHODS We conducted five semi-structured focus group interviews based on a vignette-technique with Syrian refugees (n = 21 men, n = 10 women). The vignettes describe a fictional person suffering from symptoms of PTSD or depression in line with DSM-5 and ICD-10 criteria. RESULTS Despite never mentioning PTSD, participants in the PTSD-interviews recognized the symptoms. They perceived them as a common reaction to extreme situations, mainly the war, the flight, and post-migratory stressors. Depression was labeled as either depression or feelings caused by social problems, and the participants were more hesitant to identify with these symptoms. Despite some differences, both the PTSD and depression vignettes were explained in terms of situational explanatory models and externally caused stress. The main finding is how participants described changing stressors resulting from migration and resettlement leading to a difference in how they would seek help in Syria and in Norway. Specifically, we found that preferred help-seeking and coping strategies are contextual. CONCLUSIONS These findings point to the need to consider transformations following forced migration when studying aspects of explanatory models, preferred help-seeking, and coping strategies in refugee groups.
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Affiliation(s)
- V Aarethun
- University of Bergen, Faculty of Psychology, Department of Psychosocial Science, Christies gate 12, 5015, Bergen, Norway.
| | - G M Sandal
- University of Bergen, Faculty of Psychology, Department of Psychosocial Science, Christies gate 12, 5015, Bergen, Norway.
| | - E Guribye
- NORCE Research, Universitetsveien 19, 4630, Kristiansand, Norway.
| | - V Markova
- University of Bergen, Faculty of Psychology, Department of Psychosocial Science, Christies gate 12, 5015, Bergen, Norway; SEMI, Center for Migration Health, Bergen Municipality, Norway.
| | - H H Bye
- University of Bergen, Faculty of Psychology, Department of Psychosocial Science, Christies gate 12, 5015, Bergen, Norway.
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12
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Markova V, Sandal GM, Guribye E. What Do Immigrants From Various Cultures Think Is the Best Way to Cope With Depression? Introducing the Cross-Cultural Coping Inventory. Front Psychol 2020; 11:1599. [PMID: 32760328 PMCID: PMC7372913 DOI: 10.3389/fpsyg.2020.01599] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2019] [Accepted: 06/15/2020] [Indexed: 11/25/2022] Open
Abstract
The aim of this study is to introduce a domain-specific instrument, the Cross-Cultural Depression Coping Inventory (CCD-CI), to assess ways in which people from different cultures prefer to cope with depression. Part 1 of this paper describes the development of CCD-CI. A combined etic and emic approach in generating items was used. Principal component analysis on data from a heterogeneous sample of immigrants (N = 458) supported a three-factor solution labeled: Engagement, disengagement, and spiritual coping. In Part 2 confirmatory factor analysis were conducted to test if the factors replicated in a mixed ethnic sample of immigrants from Russia (n = 164), Poland (n = 127), Pakistan (n = 128), Somalia (n = 114), and Norwegian students (n = 248). The three-factor model fits the data well and differentiated between the ethnic groups. Most significantly, Somali followed by the Pakistani immigrants scored higher on disengagement and spiritual coping. Inspection of item-level differences showed the largest ethnic variations in coping behavior of communal or social nature. The CCD-CI factors were validated against the Vancouver Index of Acculturation. Adoption to majority culture correlated positively with engagement and negatively with spiritual Coping. Maintenance of origin culture was positively associated with both spiritual coping and disengagement. In Part 3 the construct validity of the CCD-CI was tested in relation to the Brief Cope. The magnitude of the correlations was small to moderate. Taken together results indicate that CCD-CI is a reliable and valid measure of coping strategies related to depression, suitable for adults from different ethnic groups. Implications for research and clinical practice are discussed.
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Affiliation(s)
- Valeria Markova
- Department of Pulmonology, Haukeland University Hospital, Bergen, Norway.,Department of Psychosocial Science, University of Bergen, Bergen, Norway
| | - Gro M Sandal
- Department of Psychosocial Science, University of Bergen, Bergen, Norway
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13
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Pham TD. Visual Computing of Causality in Personalized Depression. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2020; 2020:5510-5513. [PMID: 33019227 DOI: 10.1109/embc44109.2020.9176637] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Major depressive disorder or clinical depression is a mental disorder characterized by daily low moods, which occur across many situations. Individuals suffering from depression are typically treated with counseling and antidepressant medication. This paper presents a computing approach for visualizing the dynamics of pairwise interactions of moods in personalized depression under and without medication. The methods of fuzzy cross recurrence plots of time series and their tensor decomposition offer a new way for gaining insight into the causality of the complex behavior of depression and its treatment.
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Apolinário-Hagen J, Hennemann S, Kück C, Wodner A, Geibel D, Riebschläger M, Zeißler M, Breil B. Exploring User-Related Drivers of the Early Acceptance of Certified Digital Stress Prevention Programs in Germany. Health Serv Insights 2020; 13:1178632920911061. [PMID: 32206013 PMCID: PMC7074489 DOI: 10.1177/1178632920911061] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2020] [Accepted: 02/14/2020] [Indexed: 12/29/2022] Open
Abstract
Electronic mental health services represent innovative instruments to increase the dissemination of stress programs in primary prevention. However, little is known about facilitators of their uptake. This study aimed to explore determinants of the acceptance of centrally certified digital stress coping programs and preferences for service delivery modes among adult members of German statutory health insurances. Participants completed a multi-construct 45-item questionnaire covering acceptance of digital stress prevention (behavioral use intention) and potential predictors we assessed using hierarchical regression analysis-(1) socio-demographic variables and time spent online, (2) openness to experience, (3) perceived stress, and (4) attitudes toward e-mental health. Preferences in terms of the willingness to use online, face-to-face and blended programs were analyzed using paired t-tests. Participants (N = 171, 66% female, 18-69 years) reported a moderate acceptance of digital stress management (M = 2.76, SD = 1.16, range: 1-5). We identified younger age (ß = -0.16, P = .009), openness to experience (ß = 0.17, P = .003), and positive attitudes (ß = 0.61, P < .001) as predictors of acceptance (R 2 = .50, P < .001). Face-to-face was preferred over online (d = 0.40) and blended (d = 0.33), and blended over stand-alone online delivery mode (d = 0.19; all P < .001). Our findings indicate that promoting favorable attitudes toward digital stress prevention through tailored information may be a starting point to facilitate their adoption.
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Affiliation(s)
- Jennifer Apolinário-Hagen
- Institute of Occupational, Social and Environmental Medicine, Centre for Health and Society, Faculty of Medicine, University Hospital Düsseldorf, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Severin Hennemann
- Department of Clinical Psychology, Psychotherapy and Experimental Psychopathology, Institute of Psychology, University of Mainz, Mainz, Germany
| | - Christina Kück
- Faculty of Psychology, University of Hagen, Hagen, Germany
| | | | - Dorota Geibel
- Faculty of Psychology, University of Hagen, Hagen, Germany
| | | | - Martin Zeißler
- Faculty of Psychology, University of Hagen, Hagen, Germany
| | - Bernhard Breil
- Faculty of Health Care, Hochschule Niederrhein, University of Applied Sciences, Krefeld, Germany
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Read J, Renton J, Harrop C, Geekie J, Dowrick C. A survey of UK general practitioners about depression, antidepressants and withdrawal: implementing the 2019 Public Health England report. Ther Adv Psychopharmacol 2020; 10:2045125320950124. [PMID: 32922735 PMCID: PMC7457636 DOI: 10.1177/2045125320950124] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2020] [Accepted: 07/22/2020] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND In 2019, a literature review indicated that more than half of people who try to come off antidepressants experience withdrawal effects. Both the National Institute of Health and Care Excellence and the Royal College of Psychiatrists updated their positions in line with that review, and Public Health England published a 152-page report called Dependence and withdrawal associated with some prescribed medicines: an evidence review. The report made several recommendations relevant to general practice. METHOD In order to facilitate implementation of these recommendations, an online survey was designed to explore United Kingdom general practitioner (GP) experiences, opinions, knowledge and needs in relation to depression, ADs and withdrawal. A total of 66 GPs had completed the survey when COVID-19 occurred. RESULTS In keeping with previous findings, this small sample of GPs had a predominantly psycho-social perspective on the causes of, and treatments for, depression. They broadly considered ADs effective for moderate/severe depression and ineffective for minimal/mild depression, for which they preferred psychological therapies and social prescribing. There was a marked lack of consistency in GPs' knowledge about the incidence and duration of withdrawal effects. Only a minority (29%) felt their knowledge about withdrawal was 'adequate' and fewer (17%) believed this about their 'Ability to distinguish between withdrawal effects and return of the original problem (e.g. depression)'. Two-thirds (68%) would like more training on these matters. CONCLUSION It is hoped that even this small sample will be helpful when designing, and seeking funding for, GP training programmes, and when implementing the PHE recommendations for support services, based in the primary care system, for the millions of people contemplating or initiating withdrawal from ADs every year in the UK.
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Affiliation(s)
- John Read
- School of Psychology, University of East London, Water Lane, London, E15 4LZ, UK
| | | | | | - Jim Geekie
- NHS Education for Scotland, Edinburgh, UK NHS Lothian, Scotland
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Siegle GJ, Cramer AOJ, van Eck NJ, Spinhoven P, Hollon SD, Ormel J, Strege M, Bockting CLH. Where are the breaks in translation from theory to clinical practice (and back) in addressing depression? An empirical graph-theoretic approach. Psychol Med 2019; 49:2681-2691. [PMID: 30560751 DOI: 10.1017/s003329171800363x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
BACKGROUND Research in depression has progressed rapidly over the past four decades. Yet depression rates are not subsiding and treatment success is not improving. We examine the extent to which the gap between science and practice is associated with the level of integration in how depression is considered in research and stakeholder-relevant documents. METHODS We used a network-science perspective to analyze similar uses of depression relevant terms in the Google News corpus (approximately 1 billion words) and the Web of Science database (120 000 documents). RESULTS These analyses yielded consistent pictures of insular modules associated with: (1) patient/providers, (2) academics, and (3) industry. Within academia insular modules associated with psychology, general medical, and psychiatry/neuroscience/biology were also detected. CONCLUSIONS These analyses suggest that the domain of depression is fragmented, and that advancements of relevance to one stakeholder group (academics, industry, or patients) may not translate to the others. We consider potential causes and associated responses to this fragmentation that could help to unify and advance translation from research on depression to the clinic, largely involving harmonizing employed language, bridging conceptual domains, and increasing communication across stakeholder groups.
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Affiliation(s)
- Greg J Siegle
- University of Pittsburgh, School of Medicine, Pittsburgh, PA, USA
| | | | | | | | | | - Johan Ormel
- University of Groningen, Groningen, Netherlands
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The effect of causal attributions for depression on help-seeking and treatment preferences. J Affect Disord 2019; 257:477-485. [PMID: 31319339 DOI: 10.1016/j.jad.2019.07.017] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2019] [Revised: 05/28/2019] [Accepted: 07/04/2019] [Indexed: 12/30/2022]
Abstract
BACKGROUND Depression is a leading cause of ill-health and disability globally and encouraging help-seeking and treatment engagement is a key priority of health authorities worldwide. Causal attributions for mental illness have numerous attitudinal and behavioural consequences; however, limited research has explored their implications for attitudes to treatment. This study experimentally investigates the impact of causal attributions for depression on attitudes to specific help-seeking and treatment options. METHODS In an online study, 196 participants read a vignette that emphasised either biological, social or biopsychosocial causes of a character's depression. Participants rated several help-seeking and treatment options on how helpful or harmful they would be for the individual described in the vignette and for themselves personally. RESULTS The causal attribution manipulation significantly affected treatment attitudes. Relative to social attributions, emphasising biological causes of depression significantly decreased the perceived helpfulness of lifestyle-based treatments, but did not affect attitudes to psychotherapeutic or medical treatment options. Participants rated most help-seeking and treatment options as less helpful for themselves compared to the vignette character. Participants with personal experience of depression had lower confidence in informal sources of help-seeking and greater confidence in medical treatment. LIMITATIONS Limitations include reliance on self-report measures and low reliability of certain sub-scales. CONCLUSIONS These findings suggest emphasising the biological underpinnings of depression could deter people from engaging with lifestyle-based treatment options. Promoting biopsychosocial theories of depression could increase awareness about the multifactorial causes of depression without negatively impacting the perceived efficacy of any help-seeking or intervention options.
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Cultural adaptations of CBT: a summary and discussion of the Special Issue on Cultural Adaptation of CBT. COGNITIVE BEHAVIOUR THERAPIST 2019. [DOI: 10.1017/s1754470x19000278] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
AbstractCognitive behavioural therapy (CBT) in its current form might not be acceptable to service users from a variety of backgrounds. Therefore, it makes sense to adapt CBT when working with diverse populations. Contributors to this special issue of theCognitive Behaviour Therapisthave tackled the issues around the cultural adaptation of CBT from various perspectives, using a variety of methods, and have addressed topics ranging from cultural adaptation to improving access to CBT. Here, I briefly summarize and discuss the papers in this special issue. I start with a systematic review of CBT for social anxiety across cultures. Seven articles cover aspects of adaptation of therapies for people from different backgrounds. Three papers discuss the issues of gender and sexuality when using CBT, while another three papers focus on refugees, asylum seekers and the homeless, and two papers describe the application of CBT with religious populations. Finally, there are seven papers on issues related to service delivery, practice and training and supervision when working with a diverse population. Collectively, papers in this special issue provide us with sufficient evidence that cultural considerations play a vital role when using CBT, offer practical suggestions for improving cultural competence and most importantly, can catalyse future research. However, the full potential of culturally adapted interventions will not be realized until and unless access to CBT is improved. Therefore, there is a need to build robust evidence to convince funders, policy makers and service managers.
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Snycerski S, Laraway S, Gregg J, Capriotti M, Callaghan GM. Implications of Behavioral Narratology for Psychotherapy, Help-Seeking Behavior, and Substance Use. Perspect Behav Sci 2018; 41:517-540. [PMID: 31976409 PMCID: PMC6701505 DOI: 10.1007/s40614-018-00182-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
Affiliation(s)
- Susan Snycerski
- Department of Psychology, San José State University, San José, CA 95192-0120 USA
| | - Sean Laraway
- Department of Psychology, San José State University, San José, CA 95192-0120 USA
| | - Jennifer Gregg
- Department of Psychology, San José State University, San José, CA 95192-0120 USA
| | - Matthew Capriotti
- Department of Psychology, San José State University, San José, CA 95192-0120 USA
- Department of Medicine, Division of Nephrology, University of California, San Francisco, CA USA
| | - Glenn M. Callaghan
- Department of Psychology, San José State University, San José, CA 95192-0120 USA
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20
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Grupp F, Moro MR, Nater UM, Skandrani SM, Mewes R. "It's That Route That Makes Us Sick": Exploring Lay Beliefs About Causes of Post-traumatic Stress Disorder Among Sub-saharan African Asylum Seekers in Germany. Front Psychiatry 2018; 9:628. [PMID: 30534091 PMCID: PMC6275318 DOI: 10.3389/fpsyt.2018.00628] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2018] [Accepted: 11/06/2018] [Indexed: 11/26/2022] Open
Abstract
Many asylum seekers have been confronted with traumatizing events, leading to high prevalence rates of post-traumatic stress disorder (PTSD). Within the diagnostic context, clinicians should take into account patients' culturally shaped presentation of symptoms. Therefore, we sought to provide insights into beliefs about causes of PTSD held by Sub-Saharan African asylum seekers living in Germany. To this aim, we used a quantitative and qualitative methodological triangulation strategy based on a vignette describing symptoms of PTSD. In the first part of the study, asylum seekers (n = 119), predominantly from Eritrea (n = 41), Somalia (n = 36), and Cameroon (n = 25), and a German comparison sample without a migration background (n = 120) completed the Revised Illness Perception Questionnaire (IPQ-R). In the second part, asylum seekers reviewed the results within eight focus group discussions (n = 26), sampled from groups of the three main countries of origin. Descriptive analyses of the first part demonstrated that asylum seekers predominantly attributed PTSD symptoms to psychological and religious causes, and rather disagreed with supernatural causes. In comparison to the German sample without a migration background, asylum seekers attributed symptoms less strongly to terrible experiences, but more strongly to religious and supernatural causes. Within the focus group discussions, six attribution categories of participants' causal beliefs were identified: (a) traumatic life experiences, (b) psychological causes, (c) social causes, (d) post-migration stressors, (e) religious causes, and (f) supernatural causes. Our findings suggest that the current Western understanding of PTSD is as relevant to migrants as to non-migrants in terms of psychological causation, but might differ regarding the religious and supernatural realm. While awareness of culture-specific belief systems of asylum seekers from Sub-Saharan Africa regarding PTSD is important, our findings do underline, at the same time, that cultural differences should not be overstated.
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Affiliation(s)
- Freyja Grupp
- Division of Clinical Biopsychology, Department of Psychology, University of Marburg, Hesse, Germany
| | - Marie Rose Moro
- University of Paris Descartes, Hospital Cochin Paris, Paris, France
| | - Urs M Nater
- Division of Clinical Psychology, Faculty of Psychology, University of Vienna, Vienna, Austria
| | - Sara M Skandrani
- University of Paris Nanterre, Hospital Cochin Paris, Paris, France
| | - Ricarda Mewes
- Outpatient Unit for Research, Teaching and Practice, Faculty of Psychology, University of Vienna, Vienna, Austria
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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.
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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
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22
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Haddad M, Waqas A, Qayyum W, Shams M, Malik S. The attitudes and beliefs of Pakistani medical practitioners about depression: a cross-sectional study in Lahore using the Revised Depression Attitude Questionnaire (R-DAQ). BMC Psychiatry 2016; 16:349. [PMID: 27756274 PMCID: PMC5070008 DOI: 10.1186/s12888-016-1069-1] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2016] [Accepted: 10/12/2016] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Mental disorders such as depression are common and rank as major contributors to the global burden of disease. Condition recognition and subsequent management of depression is variable and influenced by the attitudes and beliefs of clinicians as well as those of patients. Most studies examining health professionals' attitudes have been conducted in Western nations; this study explores beliefs and attitudes about depression among doctors working in Lahore, Pakistan. METHODS A cross-sectional survey conducted in 2015 used a questionnaire concerning demographics, education in psychiatry, beliefs about depression causes, and attitudes about depression using the Revised Depression Attitude Questionnaire (R-DAQ). A convenience sample of 700 non-psychiatrist medical practitioners based in six hospitals in Lahore was approached to participate in the survey. RESULTS Six hundred and one (86 %) of the doctors approached consented to participate; almost all respondents (99 %) endorsed one of various biopsychosocial causes of depression (38 to 79 % for particular causes), and 37 % (between 13 and 19 % for particular causes) noted that supernatural forces could be responsible. Supernatural causes were more commonly held by female doctors, those working in rural settings, and those with greater psychiatry specialist education. Attitudes to depression were mostly less confident or optimistic and less inclined to a generalist perspective than those of clinicians in the UK or European nations, and deterministic perspectives that depression is a natural part of aging or due to personal failings were particularly common. However, there was substantial confidence in the efficacy of antidepressants and psychological therapy. More confident and therapeutically optimistic views and a more generalist perspective about depression management were associated with a rejection of supernatural explanations of the origin of depression. CONCLUSIONS Non-psychiatrist medical practitioners in Pakistan hold a range of views about the causes of depression, with supernatural explanations held by more than a third. Depression attitudes appear less positive than among UK and European clinicians, with the notions that depression is due to a lack of stamina and will-power and a natural part of growing old being especially commonly held; more positive attitudes appear to be associated with a rejection of supernatural explanatory models of depression.
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Affiliation(s)
- Mark Haddad
- Centre for Mental Health Research, School of Health Sciences, City University London, Northampton Square, London, EC1V 0HB, UK. .,East London NHS Foundation Trust, London, UK.
| | - Ahmed Waqas
- CMH Lahore Medical College and Institute of Dentistry, Lahore, Pakistan
| | - Wahhaj Qayyum
- CMH Lahore Medical College and Institute of Dentistry, Lahore, Pakistan
| | - Maryam Shams
- CMH Lahore Medical College and Institute of Dentistry, Lahore, Pakistan
| | - Saad Malik
- CMH Lahore Medical College and Institute of Dentistry, Lahore, Pakistan
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Markova V, Sandal GM. Lay Explanatory Models of Depression and Preferred Coping Strategies among Somali Refugees in Norway. A Mixed-Method Study. Front Psychol 2016; 7:1435. [PMID: 27713719 PMCID: PMC5031692 DOI: 10.3389/fpsyg.2016.01435] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2016] [Accepted: 09/07/2016] [Indexed: 11/13/2022] Open
Abstract
Objective: Refugees are at high risk of experiencing mental health problems due to trauma in their pasts and to acculturation stress as they settle in a new country. To develop efficient health services that meet the needs of refugees from different regions, an understanding is required of how they make sense of and prefer to cope with mental health problems. This study aims to investigate lay explanatory models of depression and preferred coping strategies among Somali refugees in Norway. Methods: The study used a mixed-method design with a vignette describing a moderately depressed person based on ICD-10 criteria. Firstly, a survey study was performed among Somali refugees (n = 101). Respondents were asked to give advice to the vignette character and complete the Cross-Cultural Depression Coping Inventory and the General Help-Seeking Questionnaire. Secondly, focus group interviews (n = 10) were conducted separately with males and females to examine the relationship between the explanatory models of depression and the preferred coping strategies. Results: The participants showed a strong preference for coping with depression by religious practices and reliance on family, friends, and their ethnic/religious community, rather than by seeking professional treatment from public health services (e.g., medical doctors, psychologists). Depressive symptoms were conceptualized as a problem related to cognition (thinking too much) and emotion (sadness), but not to biological mechanisms, and they were thought to result from spiritual possession, stress as a result of social isolation, and/or past trauma. Independently of time in exile, the participants showed a strong identification with their ethnic origin and associated values. Because participants emphasized the need to obey and follow the views of elders, fathers, and spiritual leaders, these authorities seemed to be "gatekeepers" for access to mental health services. Conclusion: The results highlight that mental health programs for Somali refugees should actively involve the ethnic community, including spiritual leaders, in order to reach patients in need and to foster treatment compliance.
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Affiliation(s)
- Valeria Markova
- Department of Pulmonology, Haukeland University HospitalBergen, Norway
| | - Gro M. Sandal
- Department of Psychosocial Science, University of BergenBergen, Norway
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Abstract
BACKGROUND This study used attitude statement and vignette methodology to examine a mixed British sample's belies about the causes and consequences of depression. AIMS To test whether the group would recognise both vignettes with having depression and that the favoured cure would be Psychotherapy/Talking Cure. METHOD In all, 320 adults completed a two-part questionnaire. In the first part, they were given two vignettes describing a 30-year-old female and a 45-year-old male both with depression. They were asked what they thought (if anything) was wrong with the person and how they could best be helped. In the second part, they completed two questionnaires, one which lists 47 possible causes and the other 48 possible treatments for depression. RESULTS Most participants 'diagnosed' depression for the two vignettes although they chose very different terms and offered a variety of 'cures', including medication and counselling. The questionnaires about cause and cure factored into seven interpretable factors which were logically correlated. A series of regressions showed that sex, age, media interest, political beliefs, experience with depression and other mental illnesses as well as having known of others diagnosed with depression predicted different beliefs about the causes and cures of depression. CONCLUSION People have a detailed and multidimensional view of the causes and cures for depression which is systematically related to each other.
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Affiliation(s)
- Adrian Furnham
- Research Department of Clinical, Educational and Health Psychology, University College London, London, UK BI Norwegian Business School, Oslo, Norway
| | | | - Alixe Lay
- Department of Psychology, University of Bath, Bath, UK
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Bender A, Beller S. Current Perspectives on Cognitive Diversity. Front Psychol 2016; 7:509. [PMID: 27148118 PMCID: PMC4828464 DOI: 10.3389/fpsyg.2016.00509] [Citation(s) in RCA: 49] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2015] [Accepted: 03/24/2016] [Indexed: 01/29/2023] Open
Abstract
To what extent is cognition influenced by a person’s cultural background? This question has remained controversial in large fields of the cognitive sciences, including cognitive psychology, and is also underexplored in anthropology. In this perspective article, findings from a recent wave of cross-cultural studies will be outlined with respect to three aspects of cognition: perception and categorization, number representation and counting, and explanatory frameworks and beliefs. Identifying similarities and differences between these domains allows for general conclusions regarding cognitive diversity and helps to highlight the importance of culturally shaped content for a comprehensive understanding of cognition.
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Affiliation(s)
- Andrea Bender
- Department of Psychosocial Science, Faculty of Psychology, University of Bergen Bergen, Norway
| | - Sieghard Beller
- Department of Psychosocial Science, Faculty of Psychology, University of Bergen Bergen, Norway
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Bender A, Beller S. Probing the Cultural Constitution of Causal Cognition - A Research Program. Front Psychol 2016; 7:245. [PMID: 26941695 PMCID: PMC4763024 DOI: 10.3389/fpsyg.2016.00245] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2015] [Accepted: 02/08/2016] [Indexed: 11/13/2022] Open
Abstract
To what extent is the way people perceive, represent, and reason about causal relationships dependent on culture? While there have been sporadic attempts to explore this question, a systematic investigation is still lacking. Here, we propose that human causal cognition is not only superficially affected by cultural background, but that it is co-constituted by the cultural nature of the human species. To this end, we take stock of on-going research, with a particular focus on the methodological approaches taken: cross-species comparisons, archeological accounts, developmental studies, cross-cultural, and cross-linguistic experiments, as well as in-depth within-culture analyses of cognitive concepts, processes, and changes over time. We argue that only a combination of these approaches will allow us to integrate different components of cognition, levels of analysis, and points of view—the key requirements for a comprehensive, interdisciplinary research program to advance this field.
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Affiliation(s)
- Andrea Bender
- Department of Psychosocial Science, Faculty of Psychology, University of Bergen Bergen, Norway
| | - Sieghard Beller
- Department of Psychosocial Science, Faculty of Psychology, University of Bergen Bergen, Norway
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