Transcultural Psychiatry最新文献

The Refugee Access Service (RAS) is a triage, assessment and referral service established in Melbourne, Australia to ensure timely and appropriate mental health support for young refugees. This qualitative study sought to explore the experiences of young people aged 12-25 years, and their families, newly arrived from Iraq and Syria, who had contact with the RAS, for the purposes of further programme development. Semi-structured interviews were conducted with participants, either individually or in family groups. Thematic analysis was used to identify themes. Four key themes were identified. These were that mental health help-seeking of newly arrived young people and families is influenced by cultural norms; that trauma, grief and loss influence mental health service needs; that settlement challenges influence mental health service needs; and that the cultural responsiveness of mental health care is important to young people and families. Results highlight ways in which this service, and similar models, can improve to better meet the needs of young refugees and their families. Services should be developed in partnership with the wider operating environment. This will improve providers' understanding of communities they serve. It will also promote pathways between, and collaboration with, different types of services.

Activist burnout is a common threat to activists' personal sustainability and to a movement's effectiveness. Compared to related fields such as humanitarian aid or social work we know relatively little about mental health risks in activists or how a specific activist environment may contribute to mental health outcomes. This study examines the case of the No Borders movement in Europe, a grassroots movement fighting for migrant rights. The movement's groups are highly diverse in terms of nationality, ethnicity, culture, and religion because they are composed of refugees, migrants, and local populations. Following the vulnerability-stress-model, the article asks: which specific stressors occur in the No Borders movement? The analysis is exploratory and based on ethnographic research and qualitative interviews (N = 26). Situational Analysis (SitA) shows that: a) activists have to navigate a complex environment in which radical grassroots activism meets humanitarian emergencies, and b) in dealing with diversity and intergroup conflicts they are under pressure to live up to their political ideals. These insights led to the identification of three stressors: prefigurative betrayal, inadequate expectations, and split of life-worlds. Understanding these stressors can contribute to informing preventive measures in No Borders and in other migrant or antiracist movements.

This study was designed to examine how cultural values affected mothers' perceptions of internalizing symptoms in youth, comparing Taiwanese and U.S. samples. We hypothesized that mothers' self-reported East Asian cultural values (e.g., conformity, emotional self-control, face culture) would mediate the relationship between their country of residence and perceptions of youth's depressed mood and anhedonia. Participants were 310 mothers from the United States and 294 mothers from Taiwan. All participants responded to questions regarding their adherence to specific East Asian cultural values. Four brief vignettes about a male adolescent experiencing internalizing symptoms were presented to all participants. After reading each vignette, participants rated their perceptions of the adolescent's symptoms. Results from a series of multilevel structural equation models indicated that Taiwan mothers reported more East Asian cultural values (conformity, emotional self-control, face culture) compared to U.S. mothers, which in turn led to rating youth internalizing problems as less acceptable, more impairing, and more problematic to the family, and feeling less proud and more ashamed of the youth. There was also an inconsistent mediation effect of East Asian cultural values on the relationship between country and rating of anhedonia. The mediation pathway was non-significant for the rating of depressed mood. In conclusion, to improve cultural understanding, researchers and clinicians should consider the driving force of the observed between-group differences to ensure appropriate conceptual frameworks in a cross-cultural context. Cross-cultural differences in ratings of youth symptoms highlight the importance of a culturally sensitive approach to assessing symptoms and functional impairment in different cultural groups.

There is evidence that Asian migrants in Australia may be relatively reluctant to seek professional help for depression. Reluctance may be related to poor mental health literacy, including limited knowledge of help-seeking options and treatments, and a preference to seek help from informal networks. This study investigated Sri Lankan Australians' knowledge about managing depression by examining their hypothetical help-seeking intentions and perceptions about interventions and help-providers' helpfulness. Following Jorm's mental health literacy framework, participants (N = 374) were presented with a vignette of a Sri Lankan Australian exhibiting symptomatology consistent with Major Depressive Disorder, and asked to indicate their intentions to seek help by responding to the question: "If you had Mr Silva's problem, what would you do?". Participants also rated the likely helpfulness of various professional and informal helpers and interventions in addressing a problem akin to Mr Silva's. Participants reported being likely to seek help from GPs (35.8%), psychologists (25.7%) and friends (24.3%). Additionally, those who intended to seek informal help were significantly less likely to seek professional help, and vice versa. Furthermore, psychologists (94.1%), counsellors (93.3%), close friends (92.5%) and compatriots (91.4%) were most frequently categorised as helpful. Given participants' high endorsement of psychiatric treatment, psychological treatment, and self-help strategies such as engaging in enjoyable activities, it would be helpful for clinicians to emphasise the benefits of these interventions for managing depression. Additionally, recognising some participants' inclination towards religious practices and helpers, clinicians can consider integrating these help-seeking behaviours into therapeutic approaches. Future research is warranted to examine the predictors of help-seeking intentions.

COVID-19 has elicited polarized reactions to public health measures, fueling anti-vaccination movements worldwide which indicate that vaccine hesitancy represents a common expression of dissent. We investigate changes in cognitive (i.e., trust in government, conspiracy beliefs, vaccine attitudes, and other COVID-19-related factors) and socio-emotional factors (i.e., psychological distress and social support) over time, and examine if these factors are associated with COVID-19 vaccine hesitancy. A sample of Canadian young adults (N = 2,695; 18 to 40 years old) responded to an online survey in May/June 2021 (after the first vaccination campaign) and then in November 2021 (after vaccine mandates were introduced). Based on survey answers, participants were categorized as "not hesitant", "hesitant", and "do not intend to get vaccinated" at each time point. Results from generalized estimating equation models indicate that vaccination hesitancy decreased over time. The importance attributed to specific COVID-19-related factors (e.g., research and science about COVID-19 vaccines, opinions of friends and family) decreased whereas psychological distress increased over time. Cognitive and socio-emotional factors were associated with vaccine hesitancy, with participants who did not intend to get vaccinated reporting the lowest psychological distress scores. We argue that dissent may be an empowering way for young people to restore a sense of personal agency via the opposition to a system perceived as illegitimate and/or unfair. These results raise important questions about potential collateral effects of top-down government and public health interventions in times of crisis.

In the west, truth is being eroded by post-modernist ideas such as alternative facts. Once truth is no longer valued it is a short route through nationalistic populism to fascism. To combat this we need to establish the idea of 'veritocracy' as a form of government. A veritocracy is a democracy in which truth is so highly valued that promising to tell the truth will become a central feature of politicians' election manifestos feeding back the idea of veritocracy deeper into national culture. A proper understanding of the nature of science can support the idea of veritocracy. This proper understanding will not repeat the mythology of post-World War II philosophy and history of science, but will begin with the much more socially cognisant revolution in our understanding of science that began in the 1960s and 1970s. Nevertheless, a 'wave three' of science studies will justify science, not as a certainty-maker for policy, but as the way to bet in developing the best understanding of the observable world. The key is that science depends on moral truth in its attempts to develop correspondence truth. Science, like the law, should be a 'check and balance' in pluralist democracies and an object lesson in how to pursue truth in decision-making.

Today, in the age of the internet, during recent epidemics such as H1N1, Ebola and Covid-19, it is striking to see how old accusatory scripts are circulated and perpetuated via social media, which serve as new channels for discrimination and blame directed at traditional figures who have been scapegoated at different moments in the history of European epidemics. The article shows how the laundering of information into a cliquey network takes empirical shape during a health crisis. We do so by focusing on VKontakte, a Russian social network similar to Facebook and the 15th largest website in the world in terms of traffic. Using an ethnographic approach to social media, we show how borderline information from an open and easily accessible website is reappropriated, made explicit, and transformed into legally prohibited hate content. It also documents the ability of conspiracy theorists to use the full range of discourse production channels in a country-in this case France-that has very strict laws on hate speech, including that published on social networks. These laws are circumvented by anti-Semitic communities that spread false information in marginal, open and legal networks, thus avoiding legal proceedings.

Recent challenges to scientific authority in relation to the COVID pandemic, climate change, and the proliferation of conspiracy theories raise questions about the nature of knowledge and conviction. This article considers problems of social epistemology that are central to current predicaments about popular or public knowledge and the status of science. From the perspective of social epistemology, knowing and believing are not simply individual cognitive processes but based on participation in social systems, networks, and niches. As such, knowledge and conviction can be understood in terms of the dynamics of epistemic communities, which create specific forms of authority, norms, and practices that include styles of reasoning, habits of thought and modes of legitimation. Efforts to understand the dynamics of delusion and pathological conviction have something useful to teach us about our vulnerability as knowers and believers. However, this individual psychological account needs to be supplemented with a broader social view of the politics of knowledge that can inform efforts to create a healthy information ecology and strengthen the civil institutions that allow us to ground our action in well-informed picture of the world oriented toward mutual recognition, respect, diversity, and coexistence.

In many contemporary societies, misinformation, epistemic arrogance, and intergroup conflict pose serious threats to social cohesion and well-being. Wisdom may offer a potential antidote to these problems, with a recently identified Common Wisdom Model (CWM) suggesting that wisdom involves epistemic virtues such as intellectual humility, openness to change, and perspective-taking. However, it is unclear whether these virtues are central for folk concepts of wisdom in non-Western contexts. We explored this question by conducting focus group discussions with 174 participants from the Philippines and Sri Lanka, two countries facing socio-political and economic challenges. We found that epistemic themes were common in both countries, but more so when participants were asked to define wisdom in general terms rather than to describe how it is acquired or expressed in daily lives. Moreover, epistemic themes were more prevalent among Filipino than Sri Lankan participants, especially when the questions posed were abstract rather than concrete. We discuss how these findings relate to the CWM and the socio-cultural contexts of the two countries, and suggest that a question format should be considered in cross-cultural research on wisdom.

This essay introduces a thematic issue of Transcultural Psychiatry presenting selected papers from the 2022 McGill Advanced Study Institute in Cultural Psychiatry on "The Fragility of Truth: Social Epistemology in a Time of Polarization and Pandemic." The COVID-19 pandemic, political polarization, and the climate crisis have revealed that large segments of the population do not trust the best available knowledge and expertise in making vital decisions regarding their health, the governance of society, and the fate of the planet. What guides information-seeking, trust in authority, and decision-making in each of these domains? Articles in this issue include case studies of the dynamics of misinformation and disinformation; the adaptive functions and pathologies of belief, paranoia, and conspiracy theories; and strategies to foster and maintain diverse knowledge ecologies. Efforts to understand the psychological dynamics of pathological conviction have something useful to teach us about our vulnerability as knowers and believers. However, this individual psychological account needs to be supplemented with a broader social view of the politics of knowledge and epistemic authority that can inform efforts to create healthy information ecologies and strengthen the civic institutions and practices needed to provide well-informed pictures of the world as a basis for deliberative democracy, pluralism, and co-existence.