Culture Medicine and Psychiatry最新文献

Living with a complex chronic illness can be debilitating as people are constantly negotiating new bodily symptoms, constant treatment-seeking, readjustments to identity and routine. In Kenya, millions of people were infected with COVID-19 and surveillance of Long Covid remains limited. We interviewed 23 Kenyans seeking medical care or social support for Long Covid to understand their lived experiences. Participants reported limited access to healthcare; they also described symptoms including disabling fatigue, memory inconsistencies, and acute pain in the muscle, gut, or tissues. However, we found a unique chronic illness stigma-where people did not want to reveal that they had Long Covid because they feared of being perceived to have HIV. Participants reported feeling dismissed or disbelieved by family, friends, and clinicians and turned to online social support groups like Facebook. While some appreciated clinicians who used experimental treatment, others expressed trepidation when treatments caused them to feel sicker. The chronicity and debilitating symptoms of Long Covid may cultivate a unique stigma around the condition and point to a normalization of Long Covid with other chronic conditions, despite limited treatments. A broader understanding of Long Covid symptoms and care must be expanded to include destigmatizing the condition in Kenya.

The proliferation of filters, technologies, and aesthetic procedures has contributed to a surge in body image concerns, with individuals now able to purchase and alter specific body parts. This phenomenon intersects with considerations of self-objectification and cosmetic surgery, mediated by factors such as alienation and body image inflexibility. Moreover, cultural shifts, including the pervasive influence of artificial intelligence, shape perceptions and behaviors. Eating disorders, understood through neuroanthropological lenses, highlight the intricate interplay between culture, body image, and vulnerability to illness. Emerging questions revolve around prevention strategies, especially regarding children's exposure to social media and its impact on body image. Recent cultural events underscore contemporary body image ideals, posing challenges for future generations immersed in digital technology. Understanding the intersection of cultural influences, technological stimuli, and individual perceptions is crucial for addressing the evolving landscape of body image and mental health care.

Disasters create and intensify stress for communities, with many factors contributing to how that stress results in mental health outcomes. Guided by the stress process model, this article presents findings from a qualitative investigation of the meaning of stress among community leaders in the context of the water crisis in Flint, Michigan. Semi-structured interviews were conducted with six community leaders in Flint and analyzed using grounded theory techniques. Secondary stressors such as necessary changes to everyday routines, being discredited by government officials, and perceptions of a lack of government action and accountability were perceived to impact the community's mental health, with potentially more influence than the impact of the primary stressor of contaminated water. Findings indicate that both stressors and coping resources evolve with profound intrapersonal impact, such that proposed social coping resources become stressors when they do not meet individual or community needs or expectations.

This paper examines the embodied aesthetic experiences of late-blind individuals during tactile engagements with Enrico Castellani's Pseudo-Braille Surface artwork. The study applies a mixed computational-qualitative approach, utilizing the Atlas-Ti software for semantic analysis of interviews with 21 participants. Categories emerging from the analysis suggest a vivid relationship between touch, mental imagery, emotional well-being, and the creation of meaning. Key findings demonstrate a transformation from a traditional pedagogical approach to an immersive aesthetic experience, marked by a significant meta-cognitive shift, transitioning from practical understanding to haptic contemplation and narrative digression. Sometimes, participants initially experience negative well-being due to difficulties in interpreting tactile stimuli, but this evolves into positive well-being as they engage in an imaginative process, invoking autobiographical memories and personal narratives. The study reveals that this personal and relational encounter with original art enables participants to overcome initial feelings of inadequacy, unlock creative freedom, and attain emotional well-being. The participants' experiences are interpreted in the light of Walter Benjamin's notion of Aura, unveiling the unique and authentic interaction between viewer and artwork in the realm of haptic perception. The results advocate for the inclusion of tactile aesthetics in art appreciation, emphasizing the potential for aesthetic experiences to contribute to the well-being and empowerment of visually impaired individuals.

Mental health care is a vibrant part of child protective services in Japan, and the adoption and utilization of psychotherapeutic techniques from abroad mark a complex site of cross-cultural exchanges. This paper explores how art therapy has been brought into Japan's protection system and its implications for professional practice. Focusing on clinical psychologist Yuri and her narratives on learning art therapy, this paper utilizes an interpretive and phenomenological framework to illustrate the importance of embodied experience in delivering care and how practitioners may reform their perspectives on care by reframing their own traumatic memories. Yuri's art therapy offers a culturally contextualized view of the self as social, care purpose, and resilience.

Diagnostic labels aim to classify individuals for treatment in clinical settings. Yet, relatively little attention has been paid to the troubling messaging when a diagnostic label itself carries severe stigma and how relevant stakeholders react to it. Based on twenty-month fieldwork in Shanghai, this article analyzes the adverse effects of the diagnostic label chidai that is used to describe dementia and the relevant stakeholders' responses to the labeling threat. It focuses on the moral context in which the stigma related to dementia unfolds, the power of the medical term chidai in activating stigma, and the efforts that are put into formulating a stigma-free public health message. I found that the label chidai is not only an instance of excess stigma-that discredits one's cognitive capability and deprives one's moral status-but also an instrument used by medical authorities and governments to protect public safety. The debates on the diagnostic labels are meant to reshape new understandings of dementia and to challenge the power of medical authorities who often neglect humanity and care when they form their judgments and interpretations of disease. This paper contributes to the studies of stigma and dementia activism by highlighting the power of diagnostic labels.

The growing inclusion of people with lived experience and their carers in mental health research begs us to consider how their lived experience influences research. In this commentary, I use photographs to show how I used my personal experience of caring in creative ways to research violence against people with mental illness in Grand Forks, North Dakota. Drawing on Byron Good's use of hauntology and my personal experience, I argue for its adaptation as a framework for both analysis and visual representation using a multilayered auto-visual-ethnographic engagement centered around the local Amtrak station. I elaborate how in the basal layer the photographs stem from the interplay of mental images and ethnographic encounters to explore my subjectivity and intersubjective relations. In the second layer, I use an archival map to tie the photographs to the wider historical context of North Dakota. By doing so, I show how the Amtrak station emerges as a site for chaotic personal narratives and contested histories. In conclusion, I address this method's departure from classical photo-ethnography, arguing that such a hauntologically informed auto-visual-ethnographic engagement could help researchers incorporate their experiences of care and loss in mental health research in meaningful, creative, and sensitive ways.

The present study has explored the folk knowledge about the phenomenon of sleep paralysis in Pakistani society. The research aimed to gain a nuanced glimpse focusing on three major factors, culture, religion, and gender, that influence the lived experiences of those who face sleep paralysis. In this qualitative research, to have a holistic perception of indigenous knowledge about it, we selected both male and female participants who have experienced sleep paralysis. The findings indicate that there is an influence of Pakistani culture and religion regarding the experiences of the people with sleep paralysis, and gender is linked with the folklore on creatures that were linked to fairy tales and Islamic teachings. The study also revealed that Pakistani ethnic diversity has created a pool of versatility for identifying different experiences regarding sleep paralysis. These experiences were not just a part of the medical situation but portrayed the multicultural facets that are embedded in the individuals throughout their lives. Lastly, the study suggests that there is a complexity within the interactions between culture, religion, and gender on sleep paralysis. This needs to be further investigated to create culturally appropriate therapies that may have a favorable effect on both physical and mental health outcomes.

Myanmar has experienced decades of military dictatorship, civil wars, religious violence, economic crises, and natural disasters. While these conditions would suggest very high rates of depression and anxiety, government statistics report an exceptionally low depression rate of 0.00006%, compared to the global rate of 3.4%. This study combines analysis of epidemiological data, ethnographic observation of clinics, and in-depth interviews. I argue that Myanmar's low depression rates cannot be explained by the usual arguments about treatment gaps, lack of providers, or medication accessibility. Instead, I suggest that the military regime suppresses depression because it sees it as a form of political protest. While conditions like schizophrenia are readily diagnosed and treated as "purely biological," mood disorders are suspect expressions of dissent. Through living value theory (LVT), I explore health as a process of multimediation. The dictatorship's suppression of depression emerges as the strategic muting of medical interventions in favor of amplifying non-medical remediations.

Health and illness experiences are positioned within social and cultural contexts. Understanding the mental health and psychological distress of people living with HIV in highly affected communities is critical to addressing their needs and to ensure programming and interventions are targeted and appropriate. Grounded in the ethnomedical theoretical perspective, we conducted qualitative interviews to understand the experience and expression of psychological distress by people living with HIV in Rakai, Uganda. Participants included adults living with HIV (n = 20), health workers (counselors, peer health workers, nurses, n = 10), and key informants (n = 12). Interviews were audio recorded, transcribed/translated, coded, and analyzed using thematic analysis. Two idioms of distress, okweraliikirira (worry/apprehension) and okwenyamira (deep/many thoughts/lots of thoughts), were described as impacting people living with HIV. Both idioms were said to be alleviated by social support or counseling, but if left unaddressed could lead to more severe mental health problems and poor ART adherence. People living with HIV understand their psychological distress through culturally specific idioms; such distress can have deleterious impacts on well-being. Incorporating idioms of distress into screening and treatment for people living with HIV may improve identification of individuals in need and overall health services to address this need.