Sociocultural Framework for Psychiatric Case Formulation.

IF 1.6 4区医学 Q3 CLINICAL NEUROLOGY Journal of Nervous and Mental Disease Pub Date : 2024-01-01 Epub Date: 2023-10-14 DOI:10.1097/NMD.0000000000001721

Mitchell G Weiss, Ankita Deshmukh, Sanjeev B Sarmukaddam, Vasudeo P Paralikar

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Abstract

Abstract: A Cultural Formulation Interview (CFI) field trial in India, widely reported racist violence in the United States, and casteist and religious communal conflicts in India highlighted inattention to structural issues affecting mental health problems in the Outline for Cultural Formulation (OCF) and the CFI in the Diagnostic and Statistical Manual of Mental Disorders (Fifth Edition). Consequently, we revised the OCF as a sociocultural formulation (SCF) to better consider structures of society and culture. We studied and compared clinicians' ratings of SCF case formulations from a constructed assessment instrument (SCF Interview [SCFI]) and the CFI. Socio-cultural formulations from SCFI interviews were rated higher for details of societal structural impact, and overall interrater agreement was better. CFI interviews were rated higher for clinical rapport. Revision of the CFI should enhance consideration of structural issues and incorporate them in SCFs that better integrate assessment process and case formulation content. The need to acknowledge structural sources of mental health problems is clear, and our study indicates how a sociocultural framework may be used for that.

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精神病学案例形成的社会文化框架。

摘要：印度的一项文化表述访谈（CFI）实地试验、美国广泛报道的种族主义暴力以及印度的种姓和宗教社区冲突，突显了《文化表述大纲》（OCF）和《精神障碍诊断与统计手册》（第五版）中对影响心理健康问题的结构性问题的忽视。因此，我们将OCF作为一种社会文化表述进行了修订，以更好地考虑社会和文化结构。我们研究并比较了临床医生对构建的评估工具（SCF访谈[SFI]）和CFI中SCF病例配方的评分。SCFI访谈中的社会文化表述在社会结构影响的细节方面被评为更高，总体参与者之间的一致性更好。CFI访谈的临床融洽程度较高。修订CFI应加强对结构性问题的考虑，并将其纳入SCF，以更好地整合评估过程和案例制定内容。承认心理健康问题的结构性来源的必要性是显而易见的，我们的研究表明了如何利用社会文化框架来解决这一问题。

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来源期刊

Journal of Nervous and Mental Disease 医学-精神病学

CiteScore

2.90

自引率

5.30%

发文量

233

审稿时长

3-8 weeks

期刊介绍： The Journal of Nervous and Mental Disease publishes peer-reviewed articles containing new data or ways of reorganizing established knowledge relevant to understanding and modifying human behavior, especially that defined as impaired or diseased, and the context, applications and effects of that knowledge. Our policy is summarized by the slogan, "Behavioral science for clinical practice." We consider articles that include at least one behavioral variable, clear definition of study populations, and replicable research designs. Authors should use the active voice and first person whenever possible.