Culture Medicine and Psychiatry最新文献

Substance use disorder, as a high-risk behavior in adolescence, can underlie other high-risk behaviors, such as suicide, sexual risk behaviors, and violence. The initial step in implementing an effective program is to identify the underlying factors and assess the relevant context. Therefore, the current research aimed to gain deep insight into the sociocultural factors that contribute to high-risk behaviors in adolescent girls with substance use disorders. The present study was conducted with a qualitative approach and with conventional content analysis methodology. The participants consisted of 26 teenage girls with substance use disorders, specialists, and officials relevant to vulnerable groups (i.e., policy makers and managers in a variety of health/social sectors), as well as families of teenage girls. Data were collected via semistructured qualitative interviews and then coded after rewriting via MAX QDA software. The identified factors were assigned to four main categories, namely, gender stereotypes, unsafe context, gaps in fulfilling social health needs, and immature policies. The main challenges in the formation of risky behaviors in vulnerable adolescent girls were related to disturbances in the living environment, especially problems in cultural and social contexts, which itself was perceived as a product of shortcomings in the implementation of policies and intersectoral collaboration gaps. Therefore, it is imperative to make serious management decisions in the macro area in the framework of codified policies along with effective monitoring and evaluation during executive processes by social welfare organizations and health ministries.

This study investigates the psychological experiences of Sri Lankan Tamil Refugees (SLTRs) involving boat journeys and the refugee lives that follow. Thirty participants from rehabilitation camps in Tamil Nadu, India, were interviewed. Reflexive thematic analysis was used to analyze the responses. The two overarching themes were 'the motives and consequences of exile' and 'the complexities of refugee life.' The findings reveal that the participants experienced psychosomatic symptoms immediately upon arrival, reflecting the inner conflicts resulting from war trauma and boat crossings. They reported serious bouts of trauma during and after their crossing. The first- and second-generation participants recounted nightmares pertaining to boat journeys which contributed to hauntedness, which is a state of emotional or mental disturbance often attributed to past trauma. Refugee life is complex, encompassing hopelessness and haunted memories which are passed down to subsequent generations, leading to intergenerational trauma. The boat journey in itself is an ambivalent phenomenon blending hope and profound agony. This study is a novel attempt to gain coherent insights into the boat travel experiences of the SLTR, the dynamics of the interplay of collective unconscious mechanisms, and anxieties in exile. These insights can play a seminal role in facilitating psychological reconstruction and developing effective coping strategies.

Black and ethnic minority groups (diverse groups) face inequalities when it comes to healthcare in the United Kingdom, including access, stigma, and discrimination. Many of these diverse communities include Muslims. It is also known that barriers for Muslims especially involve accessing mental health services because of fears of stereotyping, stigma, and expected NHS incongruence with religious beliefs. Many Muslims make connections between religious attributions and mental health issues and consider religion a source of support. There have been efforts to construct an Islamic model of the self as a framework for healing in the therapeutic context for Muslim patients. This article develops an initial framework to integrate an Islamic model of the self with acceptance and commitment therapy (ACT). We will detail the rationale for this spiritual integration in the development of a potential mental health intervention for Muslim patients. We describe how ACT is useful, given the overlap of ACT's aim to increase psychological flexibility with the therapeutic and spiritual goals of Islamic Psychology. We use a case example to briefly illustrate the points of congruence between ACT and Islamic principles. This approach has the potential to enhance access to healthcare for Muslim patients via the NHS. Further work will be needed to develop a practical tool for therapists who wish to deliver an Islamic based therapy for Muslims using ACT as a framework.

The mixed-methods study aimed to explore revenge fantasies among Indians, focusing on gender and religious differences, and to evaluate the alignment between quantitative measures and qualitative expressions through drawings and narratives. The sample comprised 97 Indian women and 55 men, aged 18-56, who identified as either Hindu or Christian. Quantitative assessments included the demographics sheet, Traumatic Events Questionnaire (TEQ), and Injustice Experiences Questionnaire (IEQ). Qualitative measures involved drawings and narratives depicting a personal injustice and the participant's desired outcome for the perpetrator. Analysis employed non-parametric tests and Interpretative Phenomenological Analysis for the drawings and narratives. The findings revealed no overall gender differences in the revenge fantasies depicted in drawings, though differences emerged in the types of perpetrators and central themes in narratives. Religious affiliation influenced the type of revenge fantasy, with Hindus and Christians showing significant differences in narrative organization, central themes, and resolution. Additionally, significant correlations were found between IEQ scores and various drawing indicators (event type, perpetrator type, and hierarchy) as well as narrative themes. These results suggest that gender and religious affiliation intricately shape revenge fantasies, highlighting the importance of considering cultural and social factors in understanding responses to perceived injustices.

This article explores the potential of liberation medicine through an ethnographic account of a primary healthcare van operating in Cañada Real, an informal settlement on the margins of Madrid. Drawing from 10 years of clinical experience and anthropological inquiry, the article offers a situated analysis of "context-based medicine"; a mode of practice grounded in relationality, trust, and responsiveness to structural violence. Engaging with María Lugones' concept of pilgrimages and Hannah Arendt's idea of power with, the paper examines how this interstitial program disrupts dominant rationales within the healthcare system (gatekeeping, managerialism, and evidence-based medicine) by fostering collective, care-based alternatives. Through fieldwork and reflective practice, the author argues that the van's displacement (which is physical, institutional, and professional) creates a liminal space where emancipatory practices can emerge. While not a utopian model, the van provides a lens to imagine how clinical work might transgress spatial and institutional boundaries to align more closely with the political and ethical stakes of care.

Since the 1980s, French police forces have used less-lethal weapons (armes à létalité reduite)-meant to neutralize targets without killing them-to enforce order. At first mostly deployed against working-class and racialized citizens living in the margins of French cities, they have been used against wider sections of the population during recent demonstrations against neoliberal reform. These weapons can cause severe injury, with longstanding physical, social, and emotional consequences. Moreover, citizens who suffer these injuries endure a stigma of criminality, making widespread social recognition of their pain difficult, which motivates them to look for acknowledgement of their victimhood in court. Based on 22-months of ethnographic research amongst people who have been mutilated or wounded with these weapons during police operations, this article is divided in two parts. In the first part, I describe people's bodily sensations-anger, tension, pain, etc.-while awaiting trial and during court hearings. I show how, much like the initial police violence, the process of waiting for justice, the events in court, and the final verdicts also become a form of violence that is inscribed on their bodies. In the second part, I turn to my interlocutors' close networks of support and care. In contrast to official proceedings, these networks allow for the refusal of socially attributed criminality and the acknowledgement and validation of their pain. I argue that they create a form of reparation that could serve as a model for a liberation medicine, a core aspect of which is the recognition of socially inflicted pain.

Mental pain is commonly defined as an experience situated on a continuum between cognitive appraisal of the painful event and the affective disposition of the person experiencing it. Drawing on ethnographic material and interviews on severe psychiatric disorders in Bali and Java, I will try to understand what mental pain does to the person experiencing it, as well as to their immediate environment. To answer this question, I will first describe the salient attributes of mental pain as they emerged during my conversations with outpatients and observations of their milieu. These were a challenged "realness" of the experience of mental pain, its ability to take hold of one's subjective experience, an elusive and relational quality, and a perceived ambiguous and indeterminate temporal dimension. Moreover, I will describe the uncertainties of people navigating a severe psychiatric disorder (health, sanative, social, and behavioral uncertainties), and I will suggest that the salient attributes of mental pain contribute to the makeup of these uncertainties. Finally, this article illustrates that the interrelated nature of mental pain and experienced uncertainties can inform certain illness behaviors, particularly instances of self-isolation.

The Coyolxauhqui Imperative offers a decolonial framework for reimagining trauma and healing in psychiatric practice by drawing on the Aztec myth of Coyolxauhqui's dismemberment and celestial transformation. Challenging Western biomedical assumptions of linear recovery and pathologization of fragmentation, this paradigm centers cultural epistemologies of nepantla (liminal space), conocimiento (embodied truth-telling), and mythic temporality (cyclical reintegration). Through critical analysis of Nahuatl cosmology, Gloria Anzaldúa's theoretical expansion, and contemporary ritual practices, the model reconceives psychological crises as sacred processes of disintegration and reassembly. We delineate theoretical foundations, clinical applications (including narrative pharmacology, ritual reassembly, and decolonial charting), and policy implications that foreground communal re-membering over individual symptom suppression. The Imperative advances an integrative praxis that honors fragmentation as generative, privileges cultural sovereignty, and undermines psychiatric coloniality. Our interdisciplinary synthesis establishes pathways for culturally resonant assessments, participatory methodologies, and land-based healing initiatives. By repositioning fragmentation as luminous, this work invites psychiatry to adopt borderlands healing practices that valorize ancestral wisdom, collective narrative sovereignty, and ritual space-holding.