Transcultural Psychiatry最新文献

The aim of this study was to compare the knowledge and beliefs about attention-deficit/hyperactivity disorder (ADHD) between first-generation Chinese Canadian and European Canadian parents, and to evaluate the efficacy of an existing translated ADHD information resource to improve their ADHD literacy. A community sample of 28 first-generation Chinese Canadian and 28 European Canadian parents of elementary school-aged children completed questionnaires measuring ADHD knowledge, treatment attitudes and perceived stigma, both before and after reading an informational pamphlet about ADHD. Compared with European Canadian parents, Chinese Canadian parents initially had less knowledge and more stigma about ADHD but had greater increases in knowledge and medication acceptability after passive psychoeducation. For both groups, passive psychoeducation increased ADHD stigma, but did not impact the already high acceptability for parent training intervention. Passive psychoeducation can improve mental health literacy among ethnic minority groups, but further work needs to tailor resources to address specific gaps in mental health literacy and recognize the need for concurrent stigma-reduction methods.

Previous studies have found that Taiwanese comfort women survivors faced multiple forms of trauma from the comfort women system, and that societal prejudice against women's sexual victimization further impacted their marriages. However, there is minimal research exploring how sexual trauma may have impacted comfort women survivors' experiences of motherhood, alongside the consequences of survivors' experiences on subsequent generations. This article explores the perceptions of eight family members, including the second and third generations, of three deceased Taiwanese Han-Chinese ethnicity comfort women survivors. In particular, we trace family members' perspectives of survivors' mothering, and how family members were impacted by their mother's experiences as a comfort woman. To ensure participants' anonymity, findings are presented using composite narratives. The narratives illustrate the ways in which survivors' sexual trauma reportedly impacted survivors' family formation and mothering, and had long-term effects on survivors' offspring. According to family members, ambivalent mother-daughter relationships and conflictual relationships resulting from the preferential treatment of the male offspring were found. In addition, family members' psychological well-being, marriages, personality, and parenting were impacted by survivors' sexual trauma and conflictual family dynamics. Nevertheless, participants showed great strength and capacity under challenging circumstances and actively undertook their healing journey. We highlight the importance of providing culture-driven multilayered services for the families of comfort women survivors to foster intergenerational resilience, enabling them to continue to "walk out of the shadows" of conflict-related sexual violence.

In Japan, people who indulge in animation, comics, and games are commonly referred to as "otaku." Despite the prevalent stereotype associating otaku with socially maladaptive characteristics, empirical studies on this topic are limited. Previous studies suggest two consistent aspects of otaku: a tendency towards pessimism and excessive internet use. Moreover, research suggests that addictive internet use is associated with pessimistic cognition. For this reason, this study examined the distinguishing characteristics of internet dependence among Japanese otaku. Assuming various content within "Pathological Internet Use (PIU)" specific to otaku, we investigated whether a lack of adaptive cognition and social support predicted "generalized PIU" and whether a lack of adaptive cognition predicted otaku-specific PIU specifically in otaku-characterized individuals. We administered an online questionnaire to 1,115 respondents, who were categorized into otaku and non-otaku groups based on their responses. The results revealed significant inclination among otaku towards stronger PIU and maladaptive cognition, along with lower reported social support. In the multiple regression analysis among otaku, maladaptive cognition emerged as a significant predictor of otaku-specific PIU, and the analysis suggested a stronger association between internet-related maladaptive cognition and overall PIU, distinguishing otaku from non-otaku. In addition, while lower levels of social support did not predict Social Networking Service (SNS) addiction among non-otaku, SNS addiction among otaku was predicted by low degree of support from family members and online friends whom they had not met in person.

Implementation of community mental health in Indonesia has been limited and under-resourced. Pasung (physical restraint and confinement) is still commonly used and many people do not receive formal mental health care. While pluralistic use of traditional and faith healing and psychiatric services is common, the relationship between the two systems is ambiguous and overlooked in mental health policy. Meanwhile, examples of collaboration between health professionals and traditional and faith-based healers (TFHs) for mental health exist in various settings, including Indonesia. However, there is limited research on the lived experiences and everyday practices of those engaged in such partnerships, including mental health workers, healers, and families, and what makes them successful. This paper presents findings from the visual research project 'Together for Mental Health' to illustrate the facilitators and barriers to pluralistic collaborations in the Indonesian context. Our focus was on partnerships that were already established, rather than those implemented as part of research projects or interventions. Using visual ethnography, we observed eight case studies in locations representative of the three main religions in the country: Java (predominantly Muslim), Bali (Hindu), and Flores (Roman Catholic). We conducted filmed ethnographic observations of collaborative practices and in-depth interviews with 20 mental health professionals, 12 TFHs, 28 people living with mental health conditions, and 16 caregivers. The study found converging themes related to facilitating factors and barriers in practices of pluralistic collaboration for mental health care in Indonesia. Facilitating factors included actors' role perception and motive, openness to collaboration, and negotiations of care. Barriers included negative role perceptions, inadequate infrastructure, and unfavourable social environments. Findings suggest potential for successful collaboration between TFHs and formal mental health practitioners, drawing on lessons from existing good practices. To support future pluralistic collaboration for mental health care, incorporating these lessons into professional education and policies and stronger mental health care governance are needed.

Exposure to violence can have positive consequences for its victims, resulting in what has been called post-traumatic growth (PTG). The existing literature has discussed multiple aspects of PTG, but how civilians who are victims of violence in armed conflicts may experience PTG is less well understood. This article aims to understand civilians' strategies for coping with violence that may contribute to PTG in the context of the Swat Conflict (2007-2009) in north-western Pakistan. Because the strategies employed are context-specific, it further explores how the local Pashtunwali culture informed and influenced victims' responses. The research involved fieldwork including in-depth interviews and focus group discussions (FG) with 150 participants. A thematic analysis of the data found that victims deployed four strategies: seeking strength and refuge in religion, cultivating social connections and support, distractive measures, and individual adjustment. Although individual differences exist, local culture can influence the impact of violence and support victims' long-term recovery.

Research about the relation between migration and mental health as well as factors influencing the mental health of migrants has been growing because challenges of migration can constitute a significant mental health burden. However, its divergent findings seem to reflect group-specific differences, e.g., regarding country of origin and receiving country. Almost no empirical studies about individual migrant groups in different receiving countries have been undertaken so far. The present population-based study explores symptoms of depression, anxiety, and somatization as well as quality of life in an Austrian and a German sample of ex-Soviet Jewish migrants. We mainly investigate the relationship of religiosity and perceived xenophobic and anti-Semitic discrimination to the psychological condition of the migrants. Standardized self-report scales, specifically the Beck-Depression-Inventory-II (BDI), State-Trait-Anxiety-Inventory (STAI), Brief Symptom Inventory (BSI), and WHO Quality of Life Questionnaire (WHOQOL-BREF), were used to measure mental health. Ex-Soviet Jewish migrants in Austria showed significantly more symptoms of depression than those in Germany. Regression analyses support a protective effect of religiosity on mental health in the sample in Germany and an adverse effect of perceived discrimination in the sample in Austria. The present study reveals a less favorable situation for ex-Soviet Jewish migrants in Austria, in terms of income, residence status, and xenophobic attitudes in the local population, compared to the group in Germany. Furthermore, our data suggest that the receiving country matters for the mental health of this migrant group. However, further research is needed to support these conclusions.

Spiritual and religious experiences (SREs) are common subjective phenomena related to the awareness of transcendence, which transforms one's perception of life, death and suffering. Despite the high prevalence of SREs worldwide, not enough studies have been conducted beyond Europe and North America. To fill this gap, this study investigates the prevalence of SREs in Brazil and their association with socio-demographic variables. This online cross-sectional study includes participants from all regions of Brazil. Sixteen SREs were investigated, being categorized into 4 groups: mystical, mediumistic, psi-related and past life/near-death experiences. Prevalence was calculated as percentages and multinomial logistic regression models were used. A total of 1,053 Brazilians were included; 92% reported one SRE in their lifetime and 47.5% experienced at least one SRE frequently. Participants reported having had at least one mystical experience (35%), one psi-related experience (27.7%), and one mediumistic experience (11%). Half the sample had "felt the presence of a dead person" and 70% experienced precognitive dreams at least once. In a multivariate analysis, SREs were associated with the female gender but showed no associations with income, education, employment status and ethnicity. Mystical experiences were associated with age 55 and older. In summary, SREs are very prevalent across different strata of the population, and deserve more attention from researchers and clinicians in order to clarify their nature and implications for mental health care and research in Brazil.

In recent years, new identities have emerged for psychiatric "patients" in China, such as "users," "survivors," and "peers." This article draws on my long-term research on and engagement with the country's mental health field to explore the emergence of these identities as translations of globally circulating ideas and practices. Rather than viewing them as mere derivatives of Euro-American originals, I demonstrate that they are strategic translations initiated by activists and academics to resist the hegemony of biomedical and institutional psychiatry, and that they have created opportunities for policy and service reform, recognition, and empowerment. However, my analysis also reveals that the global and local authority these translations leverage has produced exclusion and marginalization. In particular, the mandate for self-advocacy against institutions underlying activists' promotion of the user and survivor identities could overlook people's vulnerability, dependency, and differences in communities. Meanwhile, attempts by academics like me to establish peer supporters as recognized paraprofessionals within the system could reproduce existing hierarchies and generate new frictions among persons with lived experience. I suggest that academics, activists, and other stakeholders involved in translating identities in the Global South should critically examine the processes and their potentially oppressive power effects, to reflect on our gatekeeping roles and center the diverse leadership of impacted individuals, and to boldly experiment with new forms of translation together for continuous (self-)decolonization.

Religion is central to the theory and practice of cultural psychiatry because it is an important determinant of health, wellness and resilience, and it shapes illness experience, coping and recovery. Religious identity and practice can also result in stressful situations and predicaments that lead to mental health problems. This editorial essay introduces a thematic issue of Transcultural Psychiatry on religion and spirituality and outlines key components of religious competency in clinical care. Articles in this issue present new research on the role of religion and spirituality in mental health, clinical approaches to working with religious patients, the development of religious interventions, the negative effects of religious practice, and the complex interplay between religion, culture and context. Given its central role in people's lives, religion is a key consideration in psychiatric assessment and treatment and can be an important resource for mental health promotion.

Evidence suggests that faith communities can support psychological wellbeing but can also potentially diminish wellbeing through stigma, imposed spiritualization, and marginalization. In particular, for evangelical Christianity, whose theological praxis typically accentuates literalist spiritual onto-etiologies, including the belief that mental distress can be treated solely through spiritual intervention (prayer, fasting, and deliverance), there may be negative implications for Christians with mental distress. The current qualitative survey examined the responses of 293 self-identified evangelical Christians, concerning their experiences of mental distress in relation to their church community. An inductive thematic analysis revealed five themes: 1) Tensions between Faith and Suffering; 2) Cautions about a Reductive Spiritualization; 3) Feeling Othered and Disconnected; 4) Faith as Alleviating Distress; and 5) Inviting an Integrationist Position. Findings reveal stigma and the totalizing spiritualization of mental distress can be experienced as both dismissive and invalidating and can problematize secular help-seeking. This lends support to previous research which has suggested that evangelical Christian communities tend to link mental distress to spiritual deficiencies, which can hold potentially negative consequences for their wellbeing. Nevertheless, a degree of complexity and nuance emerged whereby spiritual explanations and interventions were also experienced as sometimes helpful in alleviating suffering. Overall, findings suggest evangelical communities are increasingly adopting integrationist understandings of mental distress, whereby spiritual narratives are assimilated alongside the biopsychosocial. We argue that church communities and psychotherapeutic practitioners should support movement from a position of dichotomizing psychological suffering (e.g., spiritual vs. biopsychosocial) towards a spiritually syntonic frame, which contextualizes distress in terms of the whole person. Considerations for psychotherapeutic practice and further research are made.