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Thungana Y, Zingela Z, van Wyk S, Kim HH, Ametaj A, Stevenson A, Stroud RE, Stein DJ, Gelaye B. Psychosis screening questionnaire: Exploring its factor structure among South African adults. S Afr J Psychiatr 2023; 29:2051. [PMID: 38059200 PMCID: PMC10696556 DOI: 10.4102/sajpsychiatry.v29i0.2051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Accepted: 10/05/2023] [Indexed: 12/08/2023] Open
Abstract
Background Early detection of psychosis improves treatment outcomes, but there is limited research evaluating the validity of psychosis screening instruments, particularly in low-resourced countries. Aim This study aims to assess the construct validity and psychometric properties of the psychosis screening questionnaire (PSQ) in South Africa. Setting This study was conducted at several health centres in the Western and Eastern Cape provinces in South Africa. Methods The sample consisted of 2591 South African adults participating as controls in a multi-country case-control study of psychiatric genetics. Using confirmatory factor analysis and item response theory, we evaluated the psychometric properties of the PSQ. Results Approximately 11% of the participants endorsed at least one psychotic experience on the PSQ, and almost half of them (49%) occurred within the last 12 months. A unidimensional model demonstrated good fit (root mean square error of approximation [RMSEA] = 0.023, comparative fit index [CFI] = 0.977 and Tucker-Lewis Index [TLI] = 0.954). The mania item had the weakest association with a single latent factor (standardised factor loading = 0.14). Model fit improved after removing the mania item (RMSEA = 0.025, CFI = 0.991 and TLI = 0.972). With item response theory analysis, the PSQ provided more information at higher latent trait levels. Conclusion Consistent with prior literature, the PSQ demonstrated a unidimensional factor structure among South Africans. In our study, the PSQ in screening for psychosis performed better without the mania item, but future criterion validity studies are warranted. Contribution This study highlights that PSQ can be used to screen for early psychosis.
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Affiliation(s)
- Yanga Thungana
- Department of Psychiatry, Faculty of Health, Walter Sisulu University, Mthatha, South Africa
| | - Zukiswa Zingela
- Faculty of Health, Nelson Mandela University, Port Elizabeth, South Africa
| | - Stefan van Wyk
- Department of Psychiatry, Faculty of Health, Walter Sisulu University, Mthatha, South Africa
| | - Hannah H. Kim
- Department of Social and Behavioral Sciences, Faculty of Public Health, Harvard T.H. Chan School of Public Health, Boston, United States of America
| | - Amantia Ametaj
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, United States of America
| | - Anne Stevenson
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, United States of America
- Department of Psychiatry, Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, United States of America
- Department of Psychiatry, Faculty of Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Rocky E. Stroud
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, United States of America
- Department of Psychiatry, Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, United States of America
| | - Dan J. Stein
- Department of Psychiatry and Mental Health, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | - Bizu Gelaye
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, United States of America
- Department of Psychiatry, Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, United States of America
- Division of Global Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston, United States of America
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2
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Peled-Laskov R, Shoham E, Cojocaru L. Locus of Control Among Arab and Jewish Israeli Parolees. INTERNATIONAL JOURNAL OF OFFENDER THERAPY AND COMPARATIVE CRIMINOLOGY 2023:306624X231172649. [PMID: 37190762 DOI: 10.1177/0306624x231172649] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/17/2023]
Abstract
This research examines how participation in the Israeli Prisoner Rehabilitation Authority supervised therapy program for paroled prisoners can reinforce Jewish and Arab prisoners' locus of control given their cultural diversity. Research participants included 108 paroled prisoners who had taken part in the program during 2019 to 2020. The program appears to have made a positive contribution to participants' locus of control, particularly among Jewish parolees. For Arab parolees, the program's strongest contribution was alleviating their apprehensions about returning to prison. Possible Theoretical explanations are offered for this finding, by referring to the concept of "culture-sensitive care" and the potential contribution of a change in perspective regarding the process of ending delinquency.
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Affiliation(s)
| | | | - Lutzy Cojocaru
- Ashkelon Academic College, Ashkelon, Israel
- Bar Ilan University, Ashkelon, Israel
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3
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Johnson EC, Colbert SMC, Jeffries PW, Tillman R, Bigdeli TB, Karcher NR, Chan G, Kuperman S, Meyers JL, Nurnberger JI, Plawecki MH, Degenhardt L, Martin NG, Kamarajan C, Schuckit MA, Murray RM, Dick DM, Edenberg HJ, D’Souza DC, Di Forti M, Porjesz B, Nelson EC, Agrawal A. Associations Between Cannabis Use, Polygenic Liability for Schizophrenia, and Cannabis-related Experiences in a Sample of Cannabis Users. Schizophr Bull 2023; 49:778-787. [PMID: 36545904 PMCID: PMC10154717 DOI: 10.1093/schbul/sbac196] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
BACKGROUND AND HYPOTHESIS Risk for cannabis use and schizophrenia is influenced in part by genetic factors, and there is evidence that genetic risk for schizophrenia is associated with subclinical psychotic-like experiences (PLEs). Few studies to date have examined whether genetic risk for schizophrenia is associated with cannabis-related PLEs. STUDY DESIGN We tested whether measures of cannabis involvement and polygenic risk scores (PRS) for schizophrenia were associated with self-reported cannabis-related experiences in a sample ascertained for alcohol use disorders (AUDs), the Collaborative Study on the Genetics of Alcoholism (COGA). We analyzed 4832 subjects (3128 of European ancestry and 1704 of African ancestry; 42% female; 74% meeting lifetime criteria for an AUD). STUDY RESULTS Cannabis use disorder (CUD) was prevalent in this analytic sample (70%), with 40% classified as mild, 25% as moderate, and 35% as severe. Polygenic risk for schizophrenia was positively associated with cannabis-related paranoia, feeling depressed or anhedonia, social withdrawal, and cognitive difficulties, even when controlling for duration of daily cannabis use, CUD, and age at first cannabis use. The schizophrenia PRS was most robustly associated with cannabis-related cognitive difficulties (β = 0.22, SE = 0.04, P = 5.2e-7). In an independent replication sample (N = 1446), associations between the schizophrenia PRS and cannabis-related experiences were in the expected direction and not statistically different in magnitude from those in the COGA sample. CONCLUSIONS Among individuals who regularly use cannabis, genetic liability for schizophrenia-even in those without clinical features-may increase the likelihood of reporting unusual experiences related to cannabis use.
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Affiliation(s)
- Emma C Johnson
- Department of Psychiatry, Washington University School of Medicine, Saint Louis, MO, USA
| | - Sarah M C Colbert
- Department of Psychiatry, Washington University School of Medicine, Saint Louis, MO, USA
| | - Paul W Jeffries
- Department of Psychiatry, Washington University School of Medicine, Saint Louis, MO, USA
| | - Rebecca Tillman
- Department of Psychiatry, Washington University School of Medicine, Saint Louis, MO, USA
| | - Tim B Bigdeli
- Department of Psychiatry and Behavioral Sciences, SUNY Downstate Health Sciences University, Brooklyn, NY, USA
- Henri Begleiter Neurodynamics Lab, SUNY Downstate Health Sciences University, Brooklyn, NY, USA
| | - Nicole R Karcher
- Department of Psychiatry, Washington University School of Medicine, Saint Louis, MO, USA
| | - Grace Chan
- Department of Psychiatry, University of Connecticut, Farmington, CT, USA
- Department of Psychiatry, University of Iowa Carver College of Medicine, Iowa City, IA, USA
| | - Samuel Kuperman
- Department of Psychiatry, University of Iowa Carver College of Medicine, Iowa City, IA, USA
| | - Jacquelyn L Meyers
- Department of Psychiatry and Behavioral Sciences, SUNY Downstate Health Sciences University, Brooklyn, NY, USA
- Henri Begleiter Neurodynamics Lab, SUNY Downstate Health Sciences University, Brooklyn, NY, USA
| | - John I Nurnberger
- Department of Medical and Molecular Genetics, Indiana University School of Medicine, Indianapolis, IN, USA
- Department of Psychiatry, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Martin H Plawecki
- Department of Psychiatry, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Louisa Degenhardt
- National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, New South Wales, Australia
| | - Nicholas G Martin
- QIMR Berghofer Medical Research Institute, Brisbane, Queensland, Australia
| | - Chella Kamarajan
- Department of Psychiatry and Behavioral Sciences, SUNY Downstate Health Sciences University, Brooklyn, NY, USA
- Henri Begleiter Neurodynamics Lab, SUNY Downstate Health Sciences University, Brooklyn, NY, USA
| | - Marc A Schuckit
- Department of Psychiatry, University of California San Diego Medical School, San Diego, CA, USA
| | - Robin M Murray
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
| | - Danielle M Dick
- Department of Psychiatry, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, USA
| | - Howard J Edenberg
- Department of Medical and Molecular Genetics, Indiana University School of Medicine, Indianapolis, IN, USA
- Department of Biochemistry and Molecular Biology, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Deepak Cyril D’Souza
- Department of Psychiatry, Yale University, New Haven, CT, USA
- Psychiatry Service, VA Connecticut Healthcare System, West Haven, CT, USA
| | - Marta Di Forti
- Department of Social Genetics and Developmental Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
- South London and Maudsley NHS Mental Health Foundation Trust, London, UK
| | - Bernice Porjesz
- Department of Psychiatry and Behavioral Sciences, SUNY Downstate Health Sciences University, Brooklyn, NY, USA
- Henri Begleiter Neurodynamics Lab, SUNY Downstate Health Sciences University, Brooklyn, NY, USA
| | - Elliot C Nelson
- Department of Psychiatry, Washington University School of Medicine, Saint Louis, MO, USA
| | - Arpana Agrawal
- Department of Psychiatry, Washington University School of Medicine, Saint Louis, MO, USA
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4
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Fekih-Romdhane F, Pandi-Perumal SR, Conus P, Krebs MO, Cheour M, Seeman MV, Jahrami HA. Prevalence and risk factors of self-reported psychotic experiences among high school and college students: A systematic review, meta-analysis, and meta-regression. Acta Psychiatr Scand 2022; 146:492-514. [PMID: 36000793 DOI: 10.1111/acps.13494] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Revised: 08/17/2022] [Accepted: 08/18/2022] [Indexed: 01/29/2023]
Abstract
BACKGROUND Adolescents are at high risk of incident psychopathology. Fleeting psychotic experiences (PEs) that emerge in young people in response to stress may be warning signs that are missed by research that fails to study stressed populations, such as late high school and college/university students. Our aim in this systematic review was to conduct a meta-analysis that estimates prevalence rates of PEs in students, and to assess whether these rates differ by gender, age, culture, and COVID-19 exposure. METHOD We searched nine electronic databases, from their inception until January 31, 2022 for relevant studies. We pooled the estimates using the DerSimonian-Laird technique and random-effects meta-analysis. Our main outcome was the prevalence of self-reported PEs in high school and college/university students. We subsequently analyzed our data by age, gender, population, country, culture, evaluation tool, and COVID-19 exposure. RESULTS Out of 486 studies retrieved, a total of 59 independent studies met inclusion criteria reporting 210' 024 students from 21 different countries. Nearly one in four students (23.31%; 95% CI 18.41%-29.05%), reported having experienced PEs (heterogeneity [Q = 22,698.23 (62), p = 0.001] τ2 = 1.4418 [1.0415-2.1391], τ = 1.2007 [1.0205-1.4626], I2 = 99.7%, H = 19.13 [18.59-19.69]). The 95% prediction intervals were 04.01%-68.85%. Subgroup analyses showed that the pooled prevalence differed significantly by population, culture, and COVID-19 exposure. CONCLUSION This meta-analysis revealed high prevalence rates of self-reported PEs among teen and young adult students, which may have significance for mental health screening in school settings. An important realization is that PEs may have very different mental health meaning in different cultures.
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Affiliation(s)
- Feten Fekih-Romdhane
- Tunis El Manar University, Faculty of Medicine of Tunis, Tunis, Tunisia.,The Tunisian Center of Early Intervention is Psychiatry, Department of psychiatry "Ibn Omrane", Razi Hospital, Manouba, Tunisia
| | - Seithikurippu R Pandi-Perumal
- Somnogen Canada Inc., Toronto, Canada.,Saveetha Medical College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, Tamil Nadu, India
| | - Philippe Conus
- Service of General Psychiatry, Treatment and Early Intervention in Psychosis Program (TIPP-Lausanne), Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Marie-Odile Krebs
- Inserm, Laboratoire de Physiopathologie des maladies Psychiatriques, UMR_S1266 Institut de Psychiatrie et Neurosciences de Paris, Université Paris Descartes, Paris, France.,Institut de Psychiatrie (CNRS GDR 3557), Paris, France.,Faculté de Médecine Paris Descartes, Service Hospitalo-Universitaire, Centre Hospitalier Sainte-Anne, Université Paris Descartes, Paris, France
| | - Majda Cheour
- Tunis El Manar University, Faculty of Medicine of Tunis, Tunis, Tunisia.,The Tunisian Center of Early Intervention is Psychiatry, Department of psychiatry "Ibn Omrane", Razi Hospital, Manouba, Tunisia
| | - Mary V Seeman
- Department of Psychiatry, University of Toronto, Canada
| | - Haitham A Jahrami
- Psychiatric Hospital, Ministry of Health, Manama, Bahrain.,Department of Psychiatry, College of Medicine and Medical Sciences, Arabian Gulf University, Manama, Bahrain
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5
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Romaioli D, Chiara G, Faccio E, Miglietta R. Hearing voices as a form of inner dialogue. Using the dialogical self to turn a critical voice into an ally. COUNSELLING PSYCHOLOGY QUARTERLY 2022. [DOI: 10.1080/09515070.2022.2105306] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
Affiliation(s)
- Diego Romaioli
- Department of Philosophy, Sociology, Education and Applied Psychology, University of Padova, Padova, Italy
| | - Giacomo Chiara
- Department of Philosophy, Sociology, Education and Applied Psychology, University of Padova, Padova, Italy
| | - Elena Faccio
- Department of Philosophy, Sociology, Education and Applied Psychology, University of Padova, Padova, Italy
| | - Roberto Miglietta
- Department of Philosophy, Sociology, Education and Applied Psychology, University of Padova, Padova, Italy
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6
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Myers N, Mollel EL, Pauselli L, Chacon M, Compton M. Maasai women hearing voices: Implications for global mental health. Transcult Psychiatry 2022:13634615221111628. [PMID: 35912508 DOI: 10.1177/13634615221111628] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
There is a sparse literature on women who hear voices globally, even though there are documented gendered dimensions of distress in the context of globalization and climate change and research indicates that trauma and psychosocial stress may be related to an increased prevalence of voice-hearing or auditory verbal hallucinations (AVHs). There is also a gap in the cultural phenomenology of voice-hearing in general, as well as idioms of distress for non-western peoples. This article presents results of a mixed methods study that: 1) estimated community prevalence of voice-hearing among Maasai women in northern Tanzania; 2) examined any demographic correlates and two specific hypothesized correlates (i.e., psychological stress and potentially traumatic events); and 3) engaged women in semi-structured interviews about their everyday lives and the phenomenological experience of voice-hearing. The prevalence of voice-hearing (39.4%) in this nonclinical sample (n = 71) was quite high compared to other studies in sub-Saharan Africa. Most women also reported high psychosocial stress and traumatic life events. They also talked about gendered conditions of social adversity in a context of rapid social, economic, and climate change. Women who reported hearing voices had a statistically significantly higher level of psychological distress, met criteria for severe psychological distress, and reported more potentially traumatic life events. In a logistic regression model, psychosocial stress predicted voice-hearing. The presence of distressing voices may offer a straightforward way to quickly identify people in the community experiencing the most extreme levels of psychosocial stress and traumatic events-a potentially simple but effective screening tool for health workers on the ground.
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Affiliation(s)
- Neely Myers
- Southern Methodist University, Department of Anthropology, Dallas, Texas
- University of Texas-Southwestern Medical School, Department of Psychiatry, Dallas, Texas
| | | | - Luca Pauselli
- Icahn School of Medicine at Mount Sinai, Mount Sinai Morningside/West, Department of Psychiatry, New York, New York
| | - Marne Chacon
- Southern Methodist University, Department of Anthropology, Dallas, Texas
| | - Michael Compton
- Columbia University Vagelos College of Physicians and Surgeons
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7
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Jaya ES, Wüsten C, Alizadeh BZ, van Amelsvoort T, Bartels-Velthuis AA, van Beveren NJ, Bruggeman R, Cahn W, de Haan L, Delespaul P, Luykx JJ, Myin-Germeys I, Kahn RS, Schirmbeck F, Simons CJP, van Haren NE, van Os J, van Winkel R, Fonseca-Pedrero E, Peters E, Verdoux H, Woodward TS, Ziermans TB, Lincoln TM. Comparing psychotic experiences in low-and-middle-income-countries and high-income-countries with a focus on measurement invariance. Psychol Med 2022; 52:1509-1516. [PMID: 33023691 DOI: 10.1017/s0033291720003323] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
BACKGROUND The prevalence of psychotic experiences (PEs) is higher in low-and-middle-income-countries (LAMIC) than in high-income countries (HIC). Here, we examine whether this effect is explicable by measurement bias. METHODS A community sample from 13 countries (N = 7141) was used to examine the measurement invariance (MI) of a frequently used self-report measure of PEs, the Community Assessment of Psychic Experiences (CAPE), in LAMIC (n = 2472) and HIC (n = 4669). The CAPE measures positive (e.g. hallucinations), negative (e.g. avolition) and depressive symptoms. MI analyses were conducted with multiple-group confirmatory factor analyses. RESULTS MI analyses showed similarities in the structure and understanding of the CAPE factors between LAMIC and HIC. Partial scalar invariance was found, allowing for latent score comparisons. Residual invariance was not found, indicating that sum score comparisons are biased. A comparison of latent scores before and after MI adjustment showed both overestimation (e.g. avolition, d = 0.03 into d = -0.42) and underestimation (e.g. magical thinking, d = -0.03 into d = 0.33) of PE in LAMIC relative to HIC. After adjusting the CAPE for MI, participants from LAMIC reported significantly higher levels on most CAPE factors but a significantly lower level of avolition. CONCLUSION Previous studies using sum scores to compare differences across countries are likely to be biased. The direction of the bias involves both over- and underestimation of PEs in LAMIC compared to HIC. Nevertheless, the study confirms the basic finding that PEs are more frequent in LAMIC than in HIC.
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Affiliation(s)
- Edo S Jaya
- Psychosis Studies Research Group, Faculty of Psychology, Universitas Indonesia, Depok, Indonesia
| | - Caroline Wüsten
- Clinical Psychology and Psychotherapy, Institute of Psychology, Universität Hamburg, Hamburg, Germany
| | - Behrooz Z Alizadeh
- Genetic Risk and Outcome of Psychosis (GROUP) Investigators
- University of Groningen, University Medical Center Groningen, University Center for Psychiatry, Rob Giel Research Center, The Netherlands
| | - Therese van Amelsvoort
- Genetic Risk and Outcome of Psychosis (GROUP) Investigators
- Department of Psychiatry and Neuropsychology, Maastricht University Medical Center, School for Mental Health and Neuroscience, Maastricht, The Netherlands
| | - Agna A Bartels-Velthuis
- Genetic Risk and Outcome of Psychosis (GROUP) Investigators
- University of Groningen, University Medical Center Groningen, University Center for Psychiatry, Rob Giel Research Center, The Netherlands
| | - Nico J van Beveren
- Genetic Risk and Outcome of Psychosis (GROUP) Investigators
- Antes Center for Mental Health Care, Rotterdam, The Netherlands
- Department of Psychiatry, Erasmus MC, Rotterdam, The Netherlands
- Department of Neuroscience, Erasmus MC, Rotterdam, The Netherlands
| | - Richard Bruggeman
- Genetic Risk and Outcome of Psychosis (GROUP) Investigators
- University of Groningen, University Medical Center Groningen, University Center for Psychiatry, Rob Giel Research Center, The Netherlands
- Department of Clinical and Developmental Neuropsychology, University of Groningen, Groningen, The Netherlands
| | - Wiepke Cahn
- Genetic Risk and Outcome of Psychosis (GROUP) Investigators
- Department of Psychiatry, University Medical Center Utrecht, Brain Centre Rudolf Magnus, Utrecht University, Utrecht, The Netherlands
- Altrecht, General Mental Health Care, Utrecht, The Netherlands
| | - Lieuwe de Haan
- Genetic Risk and Outcome of Psychosis (GROUP) Investigators
- Department of Psychiatry, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
- Arkin, Institute for Mental Health, Amsterdam, The Netherlands
| | - Philippe Delespaul
- Genetic Risk and Outcome of Psychosis (GROUP) Investigators
- Department of Psychiatry and Neuropsychology, Maastricht University Medical Center, School for Mental Health and Neuroscience, Maastricht, The Netherlands
| | - Jurjen J Luykx
- Genetic Risk and Outcome of Psychosis (GROUP) Investigators
- Department of Psychiatry, University Medical Center Utrecht, Brain Centre Rudolf Magnus, Utrecht University, Utrecht, The Netherlands
- Department of Translational Neuroscience, University Medical Center Utrecht, Brain Center Rudolf Magnus, Utrecht, The Netherlands
| | - Inez Myin-Germeys
- Genetic Risk and Outcome of Psychosis (GROUP) Investigators
- Department of Neuroscience, Research Group Psychiatry, KU Leuven, Leuven, Belgium
| | - Rene S Kahn
- Genetic Risk and Outcome of Psychosis (GROUP) Investigators
- Department of Psychiatry, University Medical Center Utrecht, Brain Centre Rudolf Magnus, Utrecht University, Utrecht, The Netherlands
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Frederike Schirmbeck
- Genetic Risk and Outcome of Psychosis (GROUP) Investigators
- Department of Psychiatry, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
- Arkin, Institute for Mental Health, Amsterdam, The Netherlands
| | - Claudia J P Simons
- Genetic Risk and Outcome of Psychosis (GROUP) Investigators
- Department of Psychiatry and Neuropsychology, Maastricht University Medical Center, School for Mental Health and Neuroscience, Maastricht, The Netherlands
- GGzE Institute for Mental Health Care, Eindhoven, The Netherlands
| | - Neeltje E van Haren
- Genetic Risk and Outcome of Psychosis (GROUP) Investigators
- Department of Psychiatry, University Medical Center Utrecht, Brain Centre Rudolf Magnus, Utrecht University, Utrecht, The Netherlands
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC, Rotterdam, The Netherlands
| | - Jim van Os
- Genetic Risk and Outcome of Psychosis (GROUP) Investigators
- Department of Psychiatry, University Medical Center Utrecht, Brain Centre Rudolf Magnus, Utrecht University, Utrecht, The Netherlands
- Department of Psychosis Studies, King's College London, King's Health Partners, Institute of Psychiatry, London, UK
| | - Ruud van Winkel
- Genetic Risk and Outcome of Psychosis (GROUP) Investigators
- Department of Psychiatry and Neuropsychology, Maastricht University Medical Center, School for Mental Health and Neuroscience, Maastricht, The Netherlands
- Department of Neuroscience, Research Group Psychiatry, KU Leuven, Leuven, Belgium
| | - Eduardo Fonseca-Pedrero
- Department of Educational Sciences, University of La Rioja, La Rioja, Spain
- Centro de Investigación Biomédica en Red de Salud Mental, Oviedo, Spain
| | - Emmanuelle Peters
- Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- South London and Maudsley NHS Foundation Trust, London, UK
| | - Hélène Verdoux
- University Bordeaux, U1219 Bordeaux Population Health Research Center, Bordeaux, France
| | - Todd S Woodward
- Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada
- BC Mental Health and Addictions Research Institute, Vancouver, BC, Canada
| | - Tim B Ziermans
- Department of Psychology, University of Amsterdam, Amsterdam, The Netherlands
| | - Tania M Lincoln
- Clinical Psychology and Psychotherapy, Institute of Psychology, Universität Hamburg, Hamburg, Germany
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8
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van der Zeijst M, Veling W, Makhathini EM, Susser E, Burns JK, Hoek HW, Susser I. Ancestral calling, traditional health practitioner training and mental illness: An ethnographic study from rural KwaZulu-Natal, South Africa. Transcult Psychiatry 2021; 58:471-485. [PMID: 32151201 DOI: 10.1177/1363461520909615] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
This qualitative ethnographic study complements an epidemiological study on first episode psychosis in Vulindlela, a rural area in KwaZulu-Natal, South Africa. It focuses on two themes that emerged from our data: (1) the calling of the ancestors to become a traditional health practitioner and (2) ukuthwasa, the training to become a traditional health practitioner. The purpose of this study is to describe the ancestral calling, and to explore whether ukuthwasa may help with the management of mental disturbances, including unusual perceptual experiences. We also provide a discussion of the changing sociopolitical context of healing in KwaZulu-Natal, as a background to our study. In-depth interviews were conducted with 20 (apprentice) traditional health practitioners, formal health practitioners, patients and relatives recruited through local traditional health practitioners and a health care clinic. Our results show that the ancestral calling might announce itself with symptoms of mental illness including unusual perceptual experiences, for which some participants consider ukuthwasa as the only effective cure. We found indications that in some individuals successful completion of ukuthwasa might promote recovery from their illness and lead to a profession in which the unusual perceptual experiences become a legitimate and positively valued aspect. We suggest that - in this particular community today, which has been subject to several sociopolitical changes - ukuthwasa may be a culturally sanctioned healing process which moderates experiences that a Western psychiatric system might characterize as psychotic symptoms, providing some individuals with a lucrative and respected role in society.
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Affiliation(s)
| | | | | | - Ezra Susser
- Columbia University.,27424New York State Psychiatric Institute
| | - Jonathan K Burns
- University of KwaZulu-Natal.,171002University of Exeter Medical School
| | - Hans W Hoek
- Parnassia Psychiatric Institute, The Netherlands.,University of Groningen.,Columbia University
| | - Ida Susser
- Columbia University.,City University of New York
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9
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Mamah D, Mutiso VN, Ndetei DM. Psychotic-like experiences among 9,564 Kenyan adolescents and young adults. Psychiatry Res 2021; 302:113994. [PMID: 34029986 DOI: 10.1016/j.psychres.2021.113994] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2020] [Accepted: 05/07/2021] [Indexed: 12/16/2022]
Abstract
OBJECTIVE To investigate the prevalence and characteristics of psychotic-like experiences (PLE) in a large cohort of Kenyan adolescents and young adults. METHOD The Washington Early Recognition Center Affectivity and Psychosis (WERCAP) Screen was used to the study the 12-month prevalence of PLE's among 9,564 Kenyan youths (aged 15-25 yrs), and the rates of psychosis high-risk (HR) and medium-risk (MR) cases, based on cut-off scores. Relationships with clinical, demographic and economic profiles were investigated. RESULTS Across all participants, 72% reported having had at least one PLE over the last year. 4.6% and 30.6% were HR and MR based on symptom scores. There were similar PLE rates in females and males. PLE severity correlated with mood (r=0.67), stress (r=0.46), and autistic traits (r=0.18). PLE severity was also related to poverty, lower education attainment, and underemployment. Compared to controls, HR and MR youths were more likely to report lifetime substance use and to have more significant use. CONCLUSION Psychosis screening can provide valuable information about individuals and may help identify those who may require clinical assessment and intervention to improve outcomes. This is particularly relevant in many parts of Africa where the resources are limited for treating more advanced illness.
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Affiliation(s)
- Daniel Mamah
- Department of Psychiatry, Washington University Medical School, 660 S. Euclid, Saint Louis, Missouri, 63110, USA.
| | - Victoria N Mutiso
- Africa Mental Health Research and Training Foundation, Nairobi, Kenya
| | - David M Ndetei
- Africa Mental Health Research and Training Foundation, Nairobi, Kenya; Department of Psychiatry, University of Nairobi, Kenya
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10
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Mamah D, Cloninger CR, Mutiso VN, Gitonga I, Tele A, Ndetei DM. Personality Traits as Markers of Psychosis Risk in Kenya: Assessment of Temperament and Character. ACTA ACUST UNITED AC 2020; 1:sgaa051. [PMID: 33215089 PMCID: PMC7656989 DOI: 10.1093/schizbullopen/sgaa051] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Specific personality traits have been proposed as a schizophrenia-related endophenotype and confirmed in siblings at risk for psychosis. The relationship of temperament and character with psychosis has not been previously investigated in Africa. The study was conducted in Kenya, and involved participants at clinical high-risk (CHR) for psychosis (n = 268) and controls (n = 251), aged 15–25 years. CHR status was estimated using the Structured Interview of Psychosis-Risk Syndromes (SIPS) and the Washington Early Psychosis Center Affectivity and Psychosis (WERCAP) Screen. Student’s t-tests were used to assess group differences on the Temperament and Character Inventory (TCI). Neurocognitive functioning, stress severity, and substance use were correlated with the TCI, correcting for psychosis severity. CHR participants were more impulsive (ie, higher novelty seeking [NS]) and asocial (ie, lower reward dependence) than controls. They were also more schizotypal (ie, high self-transcendence [ST] and lower self-directedness [SD] and cooperativeness [CO] than controls). CO was related to logical reasoning, abstraction, and verbal memory. Stress severity correlated with high HA and schizotypal character traits. Lifetime tobacco use was related to NS, and lifetime marijuana use to high NS, low SD and high ST. Temperament and character of Kenyan CHR youth is similar to that observed in schizophrenia. Psychosis risk in Kenya is associated with impulsive, asocial, and schizotypal traits. CHR adolescents and young adults with schizophrenia-specific personality traits may be most at risk for developing a psychotic disorder and to require early intervention to improve outcomes.
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Affiliation(s)
- Daniel Mamah
- Department of Psychiatry, Washington University Medical School, St. Louis, MO
| | - C Robert Cloninger
- Department of Psychiatry, Washington University Medical School, St. Louis, MO
| | - Victoria N Mutiso
- Africa Mental Health Research and Training Foundation, Nairobi, Kenya
| | - Isaiah Gitonga
- Africa Mental Health Research and Training Foundation, Nairobi, Kenya
| | - Albert Tele
- Africa Mental Health Research and Training Foundation, Nairobi, Kenya
| | - David M Ndetei
- Africa Mental Health Research and Training Foundation, Nairobi, Kenya.,Department of Psychiatry, University of Nairobi, Nairobi, Kenya
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Prevalence and Correlates of Psychotic Like Experiences in a Large Community Sample of Young Adults in Tunisia. Community Ment Health J 2020; 56:991-1003. [PMID: 31900754 DOI: 10.1007/s10597-019-00542-1] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2019] [Accepted: 12/31/2019] [Indexed: 01/23/2023]
Abstract
Despite the increased focus on non-clinical psychosis populations, no community surveys have properly investigated the phenotypal expression of Psychotic like experiences (PLEs) in the Arab-Muslim world. We aimed to examine the prevalence and correlates of PLEs in a large sample of Tunisian college students. A total of 1489 students (64.3% female, aged 18-40) participated in a cross-sectional survey. The Positive Subscale of Community Assessment of Psychotic Experiences was used to measure PLEs. The rates of PLEs found in our work were relatively high compared with those found in previous international studies, with 51.4% of the participants reporting at least one positive PLE 'nearly-always'. After controling for confounding variables, other drug use in the past year represented the only substance use variable among the significant predictors in the final model. Our findings should raise awareness of the need for implementing an early intervention programs in our region.
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12
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Phenomenological characteristics and explanations of unusual perceptual experiences, thoughts and beliefs in a population sample of early adolescents. Ir J Psychol Med 2020; 39:173-184. [PMID: 32458773 DOI: 10.1017/ipm.2020.26] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
OBJECTIVES Often referred to as psychotic experiences, unusual perceptual experiences, thoughts and beliefs (UPTBs) are not uncommon in youth populations. Phenomenological studies of these experiences are lacking. This study aimed to (1) describe the phenomenological characteristics of UPTBs in a sample of young adolescents and (2) explore how young people made sense of those experiences. METHODS Participants were 53 young people aged 11-13 years from a population-based study of mental health. All met criteria for UPTBs following clinical interviews as part of the study. Documentary data on UPTBs in the form of transcribed notes, recorded during clinical interviews, were analysed using content analysis. Data on UPTBs were coded, organised into categorical themes and quantified using descriptive statistics. Qualitative themes on how participants made sense of their experiences were identified. RESULTS Participants reported UPTBs across four domains: auditory verbal, auditory non-verbal, non-auditory perceptual experiences and unusual thoughts and beliefs. UPTBs were phenomenologically rich and diverse. Young people sought to make sense of their experiences in multiple ways: normalising them, externalising them by attributing them to paranormal entities and distancing them from psychiatric explanations. Uncertainty about the source of UPTBs was identified as a superordinate theme. CONCLUSION Findings from this study offer new insights into the phenomenological qualities and characteristics of UPTBs in young adolescents. They also reveal that early adolescents may not make sense of their experiences within a psychiatric framework. These findings highlight the need to develop a more phenomenologically sensitive and nuanced approach to studying UPTBs in young people.
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Vermeiden M, Janssens M, Thewissen V, Akinsola E, Peeters S, Reijnders J, Jacobs N, van Os J, Lataster J. Cultural differences in positive psychotic experiences assessed with the Community Assessment of Psychic Experiences-42 (CAPE-42): a comparison of student populations in the Netherlands, Nigeria and Norway. BMC Psychiatry 2019; 19:244. [PMID: 31387566 PMCID: PMC6685165 DOI: 10.1186/s12888-019-2210-8] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2018] [Accepted: 07/11/2019] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Previous studies have suggested that culture impacts the experience of psychosis. The current study set out to extend these findings by examining cultural variation in subclinical positive psychotic experiences in students from The Netherlands, Nigeria, and Norway. Positive psychotic experiences were hypothesized to (i) be more frequently endorsed by, and (ii) cause less distress in Nigerian vs. Dutch and Norwegian students. METHODS Psychology students, aged 18 to 30 years, from universities in the Netherlands (n = 245), Nigeria (n = 478), and Norway (n = 162) were assessed cross-sectionally with regard to the frequency of subclinical positive psychotic experiences and related distress, using the Community Assessment of Psychic Experiences (CAPE-42). Multi-group confirmatory factor analysis and multivariate analysis of covariance were performed to assess measurement invariance of the positive symptom dimension (CAPE-Pos) and compare mean frequency and associated distress of positive psychotic experiences across study samples. RESULTS Only CAPE-Pos items pertaining to the dimensions 'strange experiences' and 'paranoia' met assumptions for (partial) measurement invariance. Frequencies of these experiences were higher in the Nigerian sample, compared to both the Dutch and Norwegian samples, which were similar. In addition, levels of experience-related distress were similar or higher in the Nigerian sample compared to respectively the Dutch and Norwegian samples. CONCLUSION Although positive psychotic experiences may be more commonly endorsed in non-Western societies, our findings do not support the notion that they represent a more benign, and hence less distressing aspect of human experience. Rather, the experience of psychotic phenomena may be just as, if not more, distressing in African than in European culture. However, observed differences in CAPE-Pos frequency and distress between samples from different cultural settings may partly reflect differences in the measure rather than in the latent trait. Future studies may therefore consider further cross-cultural adaptation of CAPE-42, in addition to explicitly examining cultural acceptance of psychotic phenomena, and environmental and other known risk factors for psychosis, when comparing and interpreting subclinical psychotic phenomena across cultural groups.
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Affiliation(s)
- Margriet Vermeiden
- Faculty of Psychology and Educational Sciences, Open University, Valkenburgerweg 177, Heerlen, 6419 AT The Netherlands
| | - Mayke Janssens
- Faculty of Psychology and Educational Sciences, Open University, Valkenburgerweg 177, Heerlen, 6419 AT The Netherlands
- Department of Psychiatry and Psychology, School for Mental Health and Neuroscience, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Viviane Thewissen
- Faculty of Psychology and Educational Sciences, Open University, Valkenburgerweg 177, Heerlen, 6419 AT The Netherlands
- Department of Psychiatry and Psychology, School for Mental Health and Neuroscience, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Esther Akinsola
- Department of Psychology, Faculty of Social Sciences, University of Lagos, Akoka, Lagos Nigeria
| | - Sanne Peeters
- Faculty of Psychology and Educational Sciences, Open University, Valkenburgerweg 177, Heerlen, 6419 AT The Netherlands
- Department of Psychiatry and Psychology, School for Mental Health and Neuroscience, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Jennifer Reijnders
- Faculty of Psychology and Educational Sciences, Open University, Valkenburgerweg 177, Heerlen, 6419 AT The Netherlands
| | - Nele Jacobs
- Faculty of Psychology and Educational Sciences, Open University, Valkenburgerweg 177, Heerlen, 6419 AT The Netherlands
- Department of Psychiatry and Psychology, School for Mental Health and Neuroscience, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Jim van Os
- Department of Psychiatry and Psychology, School for Mental Health and Neuroscience, Maastricht University Medical Centre, Maastricht, The Netherlands
- Department of Psychiatry, Brain Centre Rudolf Magnus, University Medical Centre Utrecht, Utrecht, The Netherlands
- Department of Psychosis Studies, Institute of Psychiatry, psychology and Neuroscience, King’s College, London, UK
| | - Johan Lataster
- Faculty of Psychology and Educational Sciences, Open University, Valkenburgerweg 177, Heerlen, 6419 AT The Netherlands
- Department of Psychiatry and Psychology, School for Mental Health and Neuroscience, Maastricht University Medical Centre, Maastricht, The Netherlands
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The Phenomenon of "Hearing Voices": Not Just Psychotic Hallucinations-A Psychological Literature Review and a Reflection on Clinical and Social Health. Community Ment Health J 2019; 55:811-818. [PMID: 30535890 DOI: 10.1007/s10597-018-0359-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2017] [Accepted: 12/04/2018] [Indexed: 10/27/2022]
Abstract
The phenomenon of hearing voices is currently a much-discussed topic, both in the field of research and in the field of care services. The majority of people who report "hearing voices" do not subsequently receive services or receive a diagnosis of psychopathology. This topic raises questions for professionals in the health field about the lack of tools that can help illuminate the phenomenon. The purposes of this work are (a) to highlight the psychological studies that approach the phenomenon in a non-psychopathological way and (b) to determine which concepts could aid the comprehension of the phenomenon. The method consists of a systematic review of the literature that characterizes the phenomenon of hearing voices from a non-pathological perspective. The literature offers different theoretical approaches to interpret the phenomenon in a way that is not necessarily pathological and presents new tools for examining the phenomenon. For example, a few studies state that it is possible to coexist with voices, while others indicate that it is necessary to know how to manage voices. We highlighted and discussed several concepts that can support doctors, psychiatrists and practitioners in understanding "hearer" patients, particularly attention to the context of belonging, attention to language, and the role of the sense-making process.
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Silva AHSD, Vedana KGG, Tressoldi LDS, Martin IDS, Corradi-Webster CM, Gherardi-Donato ECDS, Zanetti ACG. First-Episode Psychosis from the Perspective of Family Members. J Psychosoc Nurs Ment Health Serv 2019; 57:34-42. [PMID: 30130380 DOI: 10.3928/02793695-20180817-01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2018] [Accepted: 06/14/2018] [Indexed: 11/20/2022]
Abstract
The purpose of the current study was to explore family members' perceptions of the causes of first-episode psychosis (FEP). A qualitative study with 68 family members of patients with FEP was performed. Data were collected through semi-structured interviews and submitted for thematic analysis. The attributions for FEP were: use of psychoactive substances as a trigger; influence of genetic and personal factors; exposure to stressful life events; and lack of previous health care and knowledge about psychotic symptoms. Knowledge of possible attributions for the onset of psychosis may be valuable in optimizing early identification of individuals with FEP. [Journal of Psychosocial Nursing and Mental Health Services, 57(1), 34-42.].
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Wüsten C, Schlier B, Jaya ES, Fonseca-Pedrero E, Peters E, Verdoux H, Woodward TS, Ziermans TB, Lincoln TM. Psychotic Experiences and Related Distress: A Cross-national Comparison and Network Analysis Based on 7141 Participants From 13 Countries. Schizophr Bull 2018; 44:1185-1194. [PMID: 29982814 PMCID: PMC6192474 DOI: 10.1093/schbul/sby087] [Citation(s) in RCA: 44] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Psychotic experiences (PEs) are common in the general population but do not necessarily reflect a risk status if they occur in relative isolation or are not distressing. Emerging evidence suggests that PEs might be experienced as more benign for individuals from collectivistic low- and middle-income countries (LAMIC) compared with individualistic high-income countries (HIC). The aim of this study was to determine whether: (1) self-reported PEs are less distressing in community samples from LAMIC than from HIC; (2) the network of PEs is significantly less connected in a sample from LAMIC than from HIC. Adults from 8 HIC (n = 4669) and 5 LAMIC (n = 2472) were compared. The lifetime frequency of PEs and related distress were assessed with the Community Assessment of Psychic Experiences. We analyzed the associations of PEs with distress and country type. The interconnection of PEs was visualized by a network analysis and tested for differences in global connection strengths. The average endorsement rates of PEs were significantly higher in LAMIC than in HIC (χ2 = 1772.87, P < .01, Φcramer = 0.50). There was a universal positive correlation between higher frequency of PEs and more distress, but the distress levels controlled for frequency were significantly higher in HIC (R2 = 0.11; b = 0.26; SE = 0.01; T = 17.68; P < .001). Moreover, the network of PEs was significantly less connected in LAMIC (S = 0.40, P < .05). The findings indicate that PEs are of less clinical relevance in LAMIC compared with HIC. The universal use of current high-risk criteria might thus not be adequate without consideration of associated distress and cultural values.
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Affiliation(s)
- Caroline Wüsten
- Clinical Psychology and Psychotherapy, Institute of Psychology, Universität Hamburg, Hamburg, Germany
| | - Björn Schlier
- Clinical Psychology and Psychotherapy, Institute of Psychology, Universität Hamburg, Hamburg, Germany
| | - Edo S Jaya
- Psychosis Studies Research Group, Faculty of Psychology, Universitas Indonesia, Depok, Indonesia
| | - Eduardo Fonseca-Pedrero
- Department of Educational Sciences, University of La Rioja, La Rioja, Spain
- Centro de Investigación Biomédica en Red de Salud Mental, Oviedo, Spain
| | - Emmanuelle Peters
- Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, United Kingdom
- South London and Maudsley NHS Foundation Trust, London, United Kingdom
| | - Hélène Verdoux
- Univ. Bordeaux, U1219 Bordeaux Population Health Research Center, Bordeaux, France
| | - Todd S Woodward
- Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada
- BC Mental Health and Addictions Research Institute, Vancouver, BC, Canada
| | - Tim B Ziermans
- Department of Psychology, University of Amsterdam, Amsterdam, The Netherlands
| | - Tania M Lincoln
- Clinical Psychology and Psychotherapy, Institute of Psychology, Universität Hamburg, Hamburg, Germany
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Smith ET. Interdependent Concepts and their Independent Uses: Mental Imagery and Hallucinations. ACTA ACUST UNITED AC 2018. [DOI: 10.1162/posc_a_00278] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Kasahara-Kiritani M, Matoba T, Kikuzawa S, Sakano J, Sugiyama K, Yamaki C, Mochizuki M, Yamazaki Y. Public perceptions toward mental illness in Japan. Asian J Psychiatr 2018; 35:55-60. [PMID: 29787953 PMCID: PMC6019626 DOI: 10.1016/j.ajp.2018.05.021] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/24/2017] [Revised: 05/01/2018] [Accepted: 05/13/2018] [Indexed: 10/16/2022]
Abstract
AIM The purpose was to characterize public perceptions in Japan of mental illness and how they related to stigma-related attitudes for the same. METHODS Data were obtained using a vignette survey conducted as a part of the Stigma in Global Context - Mental Health Study and contained a nationally representative sample (n = 994). The survey was conducted using a multi-mode approach (face-to-face interviews, the drop-off-and-pick-up, postal collection) from September to December 2006, with a multi-stage probability sample of Japanese residents aged 18-64 years. Respondents were randomly assigned one of four vignette conditions that described psychiatric disorders meeting the diagnostic criteria for schizophrenia and major depressive disorder (one vignette for each gender exhibiting each diagnosis). We compared respondents' stigma-related attitudes and perceptions toward mental illness between vignettes. RESULTS Over 80% of Japanese participants believed that depressive disorder or schizophrenia could be cured via treatment. However, Japanese people still had relatively strong vigilance and denial of competency toward schizophrenia. CONCLUSIONS Participants expressed the belief that mental illnesses are curable, but stigma toward people with schizophrenia was still relatively strong.
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Affiliation(s)
- Mami Kasahara-Kiritani
- Department of Ethics Support, Kyoto University Hospital, Kyoto, Japan; Department of Family Nursing, The University of Tokyo, Tokyo, Japan.
| | - Tomoko Matoba
- Department of Human Care and Support, Faculty of Human Life Design, Toyo University, Saitama, Japan
| | - Saeko Kikuzawa
- Department of Sociology, Faculty of Social Sciences, Hosei University, Tokyo, Japan
| | - Junko Sakano
- Department of Welfare System and Health Science, Okayama Prefectural University, Okayama, Japan
| | - Katsumi Sugiyama
- Department of Social Welfare, Aomori University of Health and Welfare, Aomori, Japan
| | - Chikako Yamaki
- Center for Cancer Control and Information Services, National Cancer Center, Tokyo, Japan
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Parra A, Maschi G. Attributional Biases in Psychiatric Patients, a Religious, and a Control Group in the Assessment of a Hallucinatory Experience: The "White Christmas Test". REVISTA COLOMBIANA DE PSIQUIATRIA (ENGLISH ED.) 2018; 47:82-89. [PMID: 29754710 DOI: 10.1016/j.rcp.2017.01.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/01/2016] [Revised: 12/09/2016] [Accepted: 01/29/2017] [Indexed: 06/08/2023]
Abstract
The aim of this study was to evaluate the auditory hallucinatory experience in a clinical sample of patients with psychiatric symptoms (e.g. Schizophrenia), a religious group (eg. Christians) and a "control" group (with no mental disorder and non-religious). The sample consisted of individuals of both sexes. The patient sample was recruited in two psychiatric hospitals of Buenos Aires City, the religious from an evangelical cult, and people with no religious beliefs or previous psychiatric symptoms (control group). The Hallucinatory Experiences Questionnaire and the Oxford-Liverpool Inventory Feelings and Experiences were the measurement tools used. The White Christmas Test was also administered in order to assess the degree of vivid imagery hearing based on a version of signal detection paradigm in which the subjects think that they hear a song in the background of white noise. The results showed that patients showed greater attributional bias (compared with evangelicals and the control group), but the religious group also tended to show greater bias (although less) than the control group. In addition, patients tended to show greater schizotypal and hallucinatory experiences compared with the evangelicals and the control group, but surprisingly, the control group showed higher negative schizotypy than the religious group, which indicates that religious practices could help reduce the negative effects of schizotypy.
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Affiliation(s)
- Alejandro Parra
- Facultad de Psicología y Relaciones Humanas, Universidad Abierta Interamericana, Buenos Aires, Argentina.
| | - Gianina Maschi
- Facultad de Psicología y Relaciones Humanas, Universidad Abierta Interamericana, Buenos Aires, Argentina
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Abstract
Different cultures vary in their perceptions of mental illness (Karno & Edgerton, 1969), which can affect their utilisation of orthodox psychiatric facilities (Padillaet al, 1975; Sue, 1977). Mental health services may be seen by ethnic minorities as challenging the value of traditional support systems, reflecting dominant Western cultural values and harbouring implicitly racist psychological formulations. The clinician-patient interaction may become fraught with misunderstandings if the two parties come from different cultural backgrounds and bring distinct cultural expectations to the encounter.
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Lucas S. Assessing Transcendental Experiences vs Mental Illnesses. THE JOURNAL OF PASTORAL CARE & COUNSELING : JPCC 2017; 71:267-273. [PMID: 29224525 DOI: 10.1177/1542305017737780] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
In our experience, being able to differentiate between mental illness and transcendent experiences has led patients to remain engaged in treatment. This is important since those who have experienced religious preoccupation are the least likely to seek out mental health care. We have developed a "Transcendent Assessment Tool" to assist clinicians and clients in discerning whether an experience is a delusion or part of a transcendent experience.
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Affiliation(s)
- Shawn Lucas
- College of Registered Psychotherapists of Ontario (CRPO), Canada; Canadian Association of Spiritual Care (CASC), Canada; Emmanuel College, University of Toronto, Canada
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Hazell CM, Strauss C, Cavanagh K, Hayward M. Barriers to disseminating brief CBT for voices from a lived experience and clinician perspective. PLoS One 2017; 12:e0178715. [PMID: 28575094 PMCID: PMC5456317 DOI: 10.1371/journal.pone.0178715] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2016] [Accepted: 05/17/2017] [Indexed: 01/20/2023] Open
Abstract
Access to psychological therapies continues to be poor for people experiencing psychosis. To address this problem, researchers are developing brief interventions that address the specific symptoms associated with psychosis, i.e., hearing voices. As part of the development work for a brief Cognitive Behaviour Therapy (CBT) intervention for voices we collected qualitative data from people who hear voices (study 1) and clinicians (study 2) on the potential barriers and facilitators to implementation and engagement. Thematic analysis of the responses from both groups revealed a number of anticipated barriers to implementation and engagement. Both groups believed the presenting problem (voices and psychosis symptoms) may impede engagement. Furthermore clinicians identified a lack of resources to be a barrier to implementation. The only facilitator to engagement was reported by people who hear voices who believed a compassionate, experienced and trustworthy therapist would promote engagement. The results are discussed in relation to how these barriers could be addressed in the context of a brief intervention using CBT techniques.
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Affiliation(s)
- Cassie M. Hazell
- School of Psychology, University of Sussex, Falmer, Brighton, United Kingdom
| | - Clara Strauss
- School of Psychology, University of Sussex, Falmer, Brighton, United Kingdom
- Research and Development Department, Sussex Partnership NHS Foundation Trust, Sussex Education Centre, Hove, United Kingdom
| | - Kate Cavanagh
- School of Psychology, University of Sussex, Falmer, Brighton, United Kingdom
| | - Mark Hayward
- School of Psychology, University of Sussex, Falmer, Brighton, United Kingdom
- Research and Development Department, Sussex Partnership NHS Foundation Trust, Sussex Education Centre, Hove, United Kingdom
- * E-mail:
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On the Interconnectedness and Prognostic Value of Visual and Auditory Hallucinations in First-Episode Psychosis. Eur Psychiatry 2017; 41:122-128. [DOI: 10.1016/j.eurpsy.2016.10.011] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2016] [Revised: 10/28/2016] [Accepted: 10/28/2016] [Indexed: 01/29/2023] Open
Abstract
AbstractBackgroundVisual hallucinations (VH) are common symptoms in schizophrenia and other psychoses. An understanding of their cross-sectional and longitudinal patterns of association with auditory hallucinations (AH) is essential for developing accurate models of hallucinatory phenomena.ObjectiveThis study presents the most comprehensive examination of the association between VH and AH, and its change over time, in 1303 individuals with first-episode psychosis (FEP) and 469 individuals with chronic schizophrenia.MethodThe samples included data from the WHO multicentre study on the Determinants of Outcome of Severe Mental Disorders and the Western Australian Family Study of Schizophrenia (WAFSS). Standardized assessment of symptoms and functioning were used to examine the clinical profile and symptom co-occurrence of hallucinations over time.ResultsVH were approximately half as frequent as AH, almost always co-occurred with AH, and tended to be linked to a more severe psychopathological profile. AH and VH at baseline also predicted higher disability, risk of relapse and duration of psychosis after 1 and 2 years, especially when occurring in combination.ConclusionsThe findings point to three hallucination ‘subtypes’ with different symptom profile. The VH + AH combination signals greater psychopathology and a less favourable prognosis, than hallucinations occurring in isolation, and no hallucinations. This conclusion points to one common mechanism for all hallucinations, which can separate into distinct pathways and modalities. For a more complete clinical picture, clinicians should carefully probe for both auditory and VHs in presenting patients.
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Abstract
Negative attitudes toward people with mental illness are a widespread concern and may vary across countries. This study used a 36-item questionnaire to compare attitudes toward people with mental illness and beliefs about the causes of mental illness among medical students from the United States, Brazil, Ghana, Nigeria, and China (N = 1131). Exploratory factor analysis identified the underlying factor structure of the questionnaire, and analysis of covariance was then used to compare factors representing four nonstigmatized attitudes across students from the five countries. US Medical students scored highest on all four factors, followed by those from Brazil. Nigerian and Ghanaian students scored lowest on nonsupernatural etiology of mental illness, and Chinese students showed the lowest score on personal social acceptance and public policy acceptance of people with mental illness. Differences in medical student attitudes between these five countries suggest underlying sociocultural differences in attitudes with the more stigmatized attitudes in developing countries.
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Gecici O, Kuloglu M, Guler O, Ozbulut O, Kurt E, Onen S, Ekinci O, Yesilbas D, Caykoylu A, Emül M, Alatas G, Albayrak Y. Phenomenology of Delusions and Hallucinations in Patients with Schizophrenia. ACTA ACUST UNITED AC 2016. [DOI: 10.1080/10177833.2010.11790661] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Omer Gecici
- Akdeniz University, Faculty of Medicine, Department of Psychiatry, Antalya-Turkey
| | - Murat Kuloglu
- Fırat University, Faculty of Medicine, Department of Psychiatry, Elazig-Turkey
| | - Ozkan Guler
- Afyonkarahisar Kocatepe University, Faculty of Medicine, Department of Psychiatry, Afyonkarahisar-Turkey
| | - Omer Ozbulut
- Afyonkarahisar Kocatepe University, Faculty of Medicine, Department of Psychiatry, Afyonkarahisar-Turkey
| | - Erhan Kurt
- Bakırköy Education and Research Hospital for Neurology and Psychiatry, Department of Psychiatry, Istanbul-Turkey
| | - Sinay Onen
- Atatürk Education and Research Hospital, Department of Psychiatry, Ankara-Turkey
| | - Okan Ekinci
- Atatürk Education and Research Hospital, Department of Psychiatry, Ankara-Turkey
| | - Dilek Yesilbas
- Bakırköy Education and Research Hospital for Neurology and Psychiatry, Department of Psychiatry, Istanbul-Turkey
| | - Ali Caykoylu
- Atatürk Education and Research Hospital, Department of Psychiatry, Ankara-Turkey
| | - Murat Emül
- Istanbul University, Faculty of Medicine, Cerrahpaşa, Department of Psychiatry, Istanbul-Turkey
| | - Gazi Alatas
- Bakırköy Education and Research Hospital for Neurology and Psychiatry, Department of Psychiatry, Istanbul-Turkey
| | - Yakup Albayrak
- Atatürk Education and Research Hospital, Department of Psychiatry, Ankara-Turkey
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Yip KS. A Strengths Perspective in Understanding and Working with Clients with Psychosis and Records of Violence. JOURNAL OF HUMANISTIC PSYCHOLOGY 2016. [DOI: 10.1177/0022167805280263] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Clients labeled psychotic and having records of violence have long been seen as dangerous and resistant. Within a medical disease orientation, institutionalization, social control, and medication are applied in treating and rehabilitating these clients. By means of a case illustration, this article shows that violence and psychosis are understandable and predictable. From a strengths perspective, clients with psychosis and records of violence are victims of an oppressive social environment. Empathic understanding and normal interactions within a supportive social environment can rehabilitate them and help them to recover in the community.
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Affiliation(s)
- Kam-Shing Yip
- Department of Applied Social Sciences in the Hong Kong Polytechnic University
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Cyberbullying in a diverse society: comparing Jewish and Arab adolescents in Israel through the lenses of individualistic versus collectivist cultures. SOCIAL PSYCHOLOGY OF EDUCATION 2016. [DOI: 10.1007/s11218-016-9339-9] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Steenhuis LA, Bartels-Velthuis AA, Jenner JA, Aleman A, Bruggeman R, Nauta MH, Pijnenborg GHM. Religiosity in young adolescents with auditory vocal hallucinations. Psychiatry Res 2016; 236:158-164. [PMID: 26774188 DOI: 10.1016/j.psychres.2015.12.014] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2015] [Revised: 11/03/2015] [Accepted: 12/13/2015] [Indexed: 10/22/2022]
Abstract
The current exploratory study examined the associations between auditory vocal hallucinations (AVH) and delusions and religiosity in young adolescents. 337 children from a population-based case-control study with and without AVH, were assessed after five years at age 12 and 13, on the presence and appraisal of AVH, delusions and religiosity. AVH status (persistent, remittent, incident or control) was examined in relationship to religiosity. Results demonstrated a non-linear association between AVH and religiosity. Moderately religious adolescents were more likely to report AVH than non-religious adolescents (O.R.=2.6). Prospectively, moderately religious adolescents were more likely to have recently developed AVH than non-religious adolescents (O.R.=3.6) and strongly religious adolescents (O.R.=7.9). Of the adolescents reporting voices in this sample (16.3%), more than half reported positive voices. Religious beliefs were often described as supportive, useful or neutral (82%), regardless of the level of religiosity, for both adolescents with and without AVH. Co-occurrence of AVH and delusions, and severity of AVH were not related to religiosity. The present findings suggest there may be a non-linear association between religiosity and hearing voices in young adolescents. A speculative explanation may be that religious practices were adopted in response to AVH as a method of coping.
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Affiliation(s)
- Laura A Steenhuis
- Department of Clinical Psychology and Experimental Psychopathology, University of Groningen, Groningen, The Netherlands.
| | - Agna A Bartels-Velthuis
- Rob Giel Research Center, University Center for Psychiatry, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | | | - André Aleman
- Department of Clinical Psychology and Experimental Psychopathology, University of Groningen, Groningen, The Netherlands; Department of Neuroscience, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Richard Bruggeman
- Rob Giel Research Center, University Center for Psychiatry, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Maaike H Nauta
- Department of Clinical Psychology and Experimental Psychopathology, University of Groningen, Groningen, The Netherlands
| | - Gerdina H M Pijnenborg
- Department of Clinical Psychology and Experimental Psychopathology, University of Groningen, Groningen, The Netherlands; Department of Psychotic Disorders, GGZ Drenthe, Assen, The Netherlands
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29
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Xu Y, Chai H, Zhang B, Gao Q, Fan H, Zheng L, Mao H, Zhang Y, Wang W. Event-related potentials elicited by the Deutsch "high-low" word illusion in the patients with first-episode schizophrenia with auditory hallucinations. BMC Psychiatry 2016; 16:33. [PMID: 26892784 PMCID: PMC4758162 DOI: 10.1186/s12888-016-0747-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2015] [Accepted: 02/12/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The exact cerebral structural and functional mechanisms under the auditory verbal hallucinations (AVHs) in schizophrenia are still unclear. The Deutsch "high-low" word illusion might trigger attentional responses mimicking those under AVHs. METHODS We therefore have invited 16 patients with first-episode, paranoid schizophrenia, and 16 age- and gender-matched healthy volunteers to undergo the "oddball" event-related potentials elicited by the illusion. The clinical characteristics of patients were measured with the positive and negative symptom scale. RESULTS Besides the longer reaction time to the illusion, the standard P2 latency was shortened, the N2 latency was prolonged, and both N1 and P3 amplitudes were reduced in patients. The P3 source analyses showed the activated bilateral temporal lobes, parietal lobe and cingulate cortex in both groups, left inferior temporal gyrus in controls, and left postcentral gyrus in schizophrenia. Moreover, the N1 amplitude was positively correlated with the paranoid score in patients. CONCLUSIONS Our results were in line with previous neurophysiological and neuroimaging reports of hallucination or auditory processing in schizophrenia, and illustrated a whole process of cerebral information processing from N1 to P3, indicating this illusion had triggered a dynamic cerebral response similar to that of the AVHs had engaged.
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Affiliation(s)
- You Xu
- Department of Clinical Psychology and Psychiatry, School of Public Health, Zhejiang University College of Medicine, Hangzhou, China.
| | - Hao Chai
- Department of Clinical Psychology and Psychiatry, School of Public Health, Zhejiang University College of Medicine, Hangzhou, China.
| | - Bingren Zhang
- Department of Clinical Psychology and Psychiatry, School of Public Health, Zhejiang University College of Medicine, Hangzhou, China.
| | - Qianqian Gao
- Department of Clinical Psychology and Psychiatry, School of Public Health, Zhejiang University College of Medicine, Hangzhou, China.
| | - Hongying Fan
- Department of Clinical Psychology and Psychiatry, School of Public Health, Zhejiang University College of Medicine, Hangzhou, China.
| | - Leilei Zheng
- Department of Psychiatry, Second Affiliated Hospital, Zhejiang University College of Medicine, Hangzhou, China.
| | - Hongjing Mao
- Department of Clinical Psychology, Mental Health Center, Zhejiang University College of Medicine, Hangzhou, China.
| | - Yonghua Zhang
- Department of Clinical Psychology, Mental Health Center, Zhejiang University College of Medicine, Hangzhou, China.
| | - Wei Wang
- Department of Clinical Psychology and Psychiatry, School of Public Health, Zhejiang University College of Medicine, Hangzhou, China. .,Department of Clinical Psychology, Mental Health Center, Zhejiang University College of Medicine, Hangzhou, China.
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Kellehear A. Unusual perceptions at the end of life: limitations to the diagnosis of hallucinations in palliative medicine. BMJ Support Palliat Care 2016; 7:238-246. [DOI: 10.1136/bmjspcare-2015-001083] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2015] [Revised: 01/12/2016] [Accepted: 01/13/2016] [Indexed: 01/10/2023]
Abstract
The diagnosis of hallucination for unusual perceptions such as deathbed visions, near-death experiences, or visions of the bereaved, is unhelpful in palliative medicine both academically and clinically. This paper reviews the broad prevalence data about unusual perceptions in the general population as background to identifying the more narrow epidemiological source from which the much smaller focus on hallucinations seem to emerge. Major debates and limitations of current hallucination research are reviewed to show that current academic and clinical certainties are largely confined to unusual perceptions that can be readily linked to psychopathology, quite specific organic disease states and psychoactive drug use. Current state-of-the-art in hallucination studies does not warrant broad or uncritical use of this type of diagnosis in end-of-life care. Conclusions from interdisciplinary (as opposed to single discipline) hallucination studies suggest that the way forward for clinical and research work in palliative medicine may lie in a more biographical and cultural approach to unusual perceptions at the end of life.
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Tamayo-Agudelo W, Jaén-Moreno MJ, Luque-Luque R. [Factorial Structure of the Cardiff Anomalous Perceptions Scale (CAPS) in a Colombian Population Sample]. ACTA ACUST UNITED AC 2015; 44:213-9. [PMID: 26578472 DOI: 10.1016/j.rcp.2015.05.015] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2015] [Revised: 04/30/2015] [Accepted: 05/11/2015] [Indexed: 11/17/2022]
Abstract
BACKGROUND The continuum hypothesis of psychosis assumes that hallucinations are not exclusive of psychotic disorders. A number of psychometric tests have been developed to assess psychosis using a dimensional model. OBJECTIVES To determine the factorial structure of the Cardiff Anomalous Perceptions Scale (CAPS) for the Colombian population, and to contrast the fit of two factor models previously reported in the literature by conducting a confirmatory factor analysis (CFA). METHODS This was a cross-sectional study in which 207 subjects from the general population were assessed using the Cardiff Anomalous Perceptions Scale. RESULTS A two-factor structure with acceptable ordinal alpha coefficients (α=.88 and α=.87) was found. One factor gathered items related to multimodal perceptual alterations, and a second factor grouped items related with experiences linked to the temporal lobe. The analysis of the first factor indicated that it was dependent on cultural issues for the interpretation of sensations. The second factor appeared almost unchanged on diverse populations, suggesting its transcultural character. When comparing the models proposed by Bell et al. and Jaen-Moreno et al. using the data obtained from the sample, the confirmatory factor analysis conducted indicated inadequate goodness-of-fit indexes (χ(2)). However, some incremental goodness-of-fit indexes (normalized χ(2) [RMSEA]) were acceptable. The Jaén-Moreno et al. model showed the best fit to the data collected from the Colombian sample. CONCLUSIONS The factorial structure of CAPS for the Colombian population appears to be sensitive to cultural issues, especially when describing anomalous sensorial experiences.
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Affiliation(s)
| | - María José Jaén-Moreno
- Cátedra de Psiquiatría y Psicología Médica, Facultad de Medicina, Universidad de Córdoba, España
| | - Rogelio Luque-Luque
- Cátedra de Psiquiatría y Psicología Médica, Facultad de Medicina, Universidad de Córdoba, España
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32
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Jenkins R, Othieno C, Ongeri L, Ogutu B, Sifuna P, Kingora J, Kiima D, Ongecha M, Omollo R. Adult psychotic symptoms, their associated risk factors and changes in prevalence in men and women over a decade in a poor rural district of Kenya. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2015; 12:5310-28. [PMID: 25996885 PMCID: PMC4454969 DOI: 10.3390/ijerph120505310] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/31/2015] [Revised: 05/09/2015] [Accepted: 05/11/2015] [Indexed: 11/16/2022]
Abstract
There have been no repeat surveys of psychotic symptoms in Kenya or indeed subSaharan Africa. A mental health epidemiological survey was therefore conducted in a demographic surveillance site of a Kenyan household population in 2013 to test the hypothesis that the prevalence of psychotic symptoms would be similar to that found in an earlier sample drawn from the same sample frame in 2004, using the same overall methodology and instruments. This 2013 study found that the prevalence of one or more psychotic symptoms was 13.9% with one or more symptoms and 3.8% with two or more symptoms, while the 2004 study had found that the prevalence of single psychotic symptoms in rural Kenya was 8% of the adult population, but only 0.6% had two symptoms and none had three or more psychotic symptoms. This change was accounted for by a striking increase in psychotic symptoms in women (17.8% in 2013 compared with 6.9% in 2004, p < 0.001), whereas there was no significant change in men (10.6% in 2013 compared with 9.4% in 2004, p = 0.582). Potential reasons for this increase in rate of psychotic symptoms in women are explored.
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Affiliation(s)
- Rachel Jenkins
- Health Services and Population Research Department, Institute of Psychiatry, Kings College London, de Crespigny Park, London SE 5 8AF, UK.
| | - Caleb Othieno
- Department of Psychiatry, University of Nairobi, P.O. Box 19676-00202, Kenya.
| | - Linnet Ongeri
- Kenya Medical Research Institute, Nairobi, P.O. Box 54840-00200, Kenya.
| | - Bernards Ogutu
- Kenya Medical Research Institute, Nairobi, P.O. Box 54840-00200, Kenya.
| | - Peter Sifuna
- Kombewa Health and Demographic Surveillance Systems, Kombewa, P.O Box 54-40100, Kisumu, Kenya.
| | - James Kingora
- Kenya Medical Training College, Nairobi, P.O. Box 30195, GPO-00100, Kenya.
| | - David Kiima
- Kenya Medical Research Institute, Kisian, Kisumu P.O. Box 1578-40100, Kenya.
| | - Michael Ongecha
- Ministry of Health, Nairobi P.O. Box 30016, GPO-00100, Kenya.
| | - Raymond Omollo
- Kenya Medical Research Institute, Nairobi, P.O. Box 54840-00200, Kenya.
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Larøi F, Luhrmann TM, Bell V, Christian WA, Deshpande S, Fernyhough C, Jenkins J, Woods A. Culture and hallucinations: overview and future directions. Schizophr Bull 2014; 40 Suppl 4:S213-20. [PMID: 24936082 PMCID: PMC4141319 DOI: 10.1093/schbul/sbu012] [Citation(s) in RCA: 111] [Impact Index Per Article: 11.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2013] [Revised: 01/19/2014] [Accepted: 01/22/2014] [Indexed: 01/08/2023]
Abstract
A number of studies have explored hallucinations as complex experiences involving interactions between psychological, biological, and environmental factors and mechanisms. Nevertheless, relatively little attention has focused on the role of culture in shaping hallucinations. This article reviews the published research, drawing on the expertise of both anthropologists and psychologists. We argue that the extant body of work suggests that culture does indeed have a significant impact on the experience, understanding, and labeling of hallucinations and that there may be important theoretical and clinical consequences of that observation. We find that culture can affect what is identified as a hallucination, that there are different patterns of hallucination among the clinical and nonclinical populations, that hallucinations are often culturally meaningful, that hallucinations occur at different rates in different settings; that culture affects the meaning and characteristics of hallucinations associated with psychosis, and that the cultural variations of psychotic hallucinations may have implications for the clinical outcome of those who struggle with psychosis. We conclude that a clinician should never assume that the mere report of what seems to be a hallucination is necessarily a symptom of pathology and that the patient's cultural background needs to be taken into account when assessing and treating hallucinations.
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Affiliation(s)
- Frank Larøi
- Department of Psychology, University of Liège, Liège, Belgium
| | | | - Vaughan Bell
- King's College London, Institute of Psychiatry, London, UK
| | - William A Christian
- Department of Social Anthropology, Autonomous University of Barcelona, Bellaterra, Spain
| | - Smita Deshpande
- Department of Psychiatry and Addiction Services, Dr Ram Manohar Lohia Hospital, New Delhi, India
| | | | - Janis Jenkins
- Department of Anthropology, University of California San Diego, San Diego, CA
| | - Angela Woods
- Centre for Medical Humanities, Durham University, Durham, UK
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Corstens D, Longden E, McCarthy-Jones S, Waddingham R, Thomas N. Emerging perspectives from the hearing voices movement: implications for research and practice. Schizophr Bull 2014; 40 Suppl 4:S285-94. [PMID: 24936088 PMCID: PMC4141309 DOI: 10.1093/schbul/sbu007] [Citation(s) in RCA: 134] [Impact Index Per Article: 13.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/02/2022]
Abstract
The international Hearing Voices Movement (HVM) is a prominent mental health service-user/survivor movement that promotes the needs and perspectives of experts by experience in the phenomenon of hearing voices (auditory verbal hallucinations). The main tenet of the HVM is the notion that hearing voices is a meaningful human experience, and in this article, we discuss the historical growth and influence of the HVM before considering the implications of its values for research and practice in relation to voice-hearing. Among other recommendations, we suggest that the involvement of voice-hearers in research and a greater use of narrative and qualitative approaches are essential. Challenges for implementing user-led research are identified, and avenues for future developments are discussed.
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Affiliation(s)
| | - Eleanor Longden
- Institute of Psychological Sciences, University of Leeds, Leeds, UK
| | - Simon McCarthy-Jones
- ARC Centre for Excellence in Cognition and Its Disorders, Macquarie University, Sydney, Australia;,Department of Psychology, Durham University, Durham, UK
| | | | - Neil Thomas
- Brain and Psychological Sciences Research Centre, Swinburne University, Melbourne, Australia;,Monash Alfred Psychiatry Research Centre, Melbourne, Australia
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35
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Galanter M, Dermatis H, Sampson C. Spiritual Awakening in Alcoholics Anonymous: Empirical Findings. ALCOHOLISM TREATMENT QUARTERLY 2014. [DOI: 10.1080/07347324.2014.907058] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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36
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Perogamvros L. Esse est percipi: a neurophilosophical model of psychosis. Psychopathology 2014; 47:275-84. [PMID: 25060543 DOI: 10.1159/000362565] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2013] [Accepted: 03/31/2014] [Indexed: 11/19/2022]
Abstract
Philosophers, psychiatrists and neuroscientists have all expressed interest in and formulated hypotheses on the nature of hallucinations, but no sufficient integration of these models exists to this date. The objective of this article is to present a neurophilosophical model of psychosis linking the neurobiology with the phenomenology of hallucinations and delusions. It is proposed that psychotic hallucinations could be regarded as 'intrusions' of subjective idealism, a condition where reality is mind dependent, into realism, a condition where reality is mind independent. Furthermore, delusions would be an attempt by the person to make sense of these intrusions. This approach is supported by phenomenological evidence of increased self-relatedness in hallucinations and delusions, and by current neurobiological evidence on the role of the reward system, default mode network and corollary discharge circuit in positive symptomatology. This model has clinical, research and therapeutic implications, and also demonstrates how scientific results can be informed and enhanced by philosophical theories and vice versa.
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Affiliation(s)
- Lampros Perogamvros
- Department of Psychiatry, Geneva University Hospitals, and Department of Neuroscience, University of Geneva, Geneva, Switzerland
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37
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First MB, Wakefield JC. Diagnostic criteria as dysfunction indicators: bridging the chasm between the definition of mental disorder and diagnostic criteria for specific disorders. CANADIAN JOURNAL OF PSYCHIATRY. REVUE CANADIENNE DE PSYCHIATRIE 2013; 58:663-9. [PMID: 24331285 DOI: 10.1177/070674371305801203] [Citation(s) in RCA: 67] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
According to the introduction to the Diagnostic and Statistical Manual of Mental Disorders (DSM), Fifth Edition, each disorder must satisfy the definition of mental disorder, which requires the presence of both harm and dysfunction. Constructing criteria sets to require harm is relatively straightforward. However, establishing the presence of dysfunction is necessarily inferential because of the lack of knowledge of internal psychological and biological processes and their functions and dysfunctions. Given that virtually every psychiatric symptom characteristic of a DSM disorder can occur under some circumstances in a normally functioning person, diagnostic criteria based on symptoms must be constructed so that the symptoms indicate an internal dysfunction, and are thus inherently pathosuggestive. In this paper, we review strategies used in DSM criteria sets for increasing the pathosuggestiveness of symptoms to ensure that the disorder meets the requirements of the definition of mental disorder. Strategies include the following: requiring a minimum duration and persistence; requiring that the frequency or intensity of a symptom exceed that seen in normal people; requiring disproportionality of symptoms, given the context; requiring pervasiveness of symptom expression across contexts; adding specific exclusions for contextual scenarios in which symptoms are best understood as normal reactions; combining symptoms to increase cumulative pathosuggestiveness; and requiring enough symptoms from an overall syndrome to meet a minimum threshold of pathosuggestiveness. We propose that future revisions of the DSM consider systematic implementation of these strategies in the construction and revision of criteria sets, with the goal of maximizing the pathosuggestiveness of diagnostic criteria to reduce the potential for diagnostic false positives.
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Affiliation(s)
- Michael B First
- Professor of Clinical Psychiatry, Department of Psychiatry, Columbia University College of Physicians and Surgeons, New York, New York; Research Psychiatrist, Division of Clinical Phenomenology, New York State Psychiatric Institute, New York, New York
| | - Jerome C Wakefield
- Professor of Social Work, Silver School of Social Work, New York University, New York, New York; Professor of Psychiatry, Department of Psychiatry, School of Medicine, New York University, New York, New York
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38
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Faccio E, Romaioli D, Dagani J, Cipolletta S. Auditory hallucinations as a personal experience: analysis of non-psychiatric voice hearers' narrations. J Psychiatr Ment Health Nurs 2013; 20:761-7. [PMID: 23067012 DOI: 10.1111/jpm.12008] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/14/2012] [Indexed: 11/29/2022]
Abstract
This exploratory research investigates the phenomenon of non-psychiatric auditory hallucinations from the perspective of the voice hearer, evaluating the possibility that this experience can contribute the maintenance and adaptation of the hearer's personal identity system. A semi-structured interview was administered to 10 Italian voice hearers, six men and four women, aged 18-65 years, who had never been in contact with any mental health services because of the voices, even though some of them had been hearing voices for decades. Participants were not distressed or worried about the voices; on the contrary they developed their own understanding, personal coping resources and beliefs in relation to the positive functions of the voices. These results indicate that voices cannot be considered merely as symptoms, but may be seen also as adaptation systems. Consequently, we should avoid trying to helping voice hearers to eliminate or deny voices, and rather we should help them to feel allowed to preserve them.
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Affiliation(s)
- E Faccio
- Department of Philosophy, Sociology, Pedagogy and Applied Psychology, University of Padua, Padova, Italy
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39
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Dimensions of hallucinations and delusions in affective and nonaffective illnesses. ISRN PSYCHIATRY 2013; 2013:616304. [PMID: 23997978 PMCID: PMC3755384 DOI: 10.1155/2013/616304] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/31/2013] [Accepted: 07/14/2013] [Indexed: 11/21/2022]
Abstract
The aim of the study was to examine the dimensions of hallucinations and delusions in affective (manic episode, bipolar affective disorder, and depressive episode) and nonaffective disorders (schizophrenia, acute and transient psychotic disorders, and unspecified psychosis). Sixty outpatients divided equally into two groups comprising affective and nonaffective disorders were taken up for evaluation after screening, as per inclusion and exclusion criteria. Scores of 3 or above on delusion and hallucinatory behavior subscales of positive and negative syndrome scale were sufficient to warrant rating on the psychotic symptom rating scales with which auditory hallucination and delusion were assessed on various dimensions. Insight was assessed using the Beck cognitive insight scale (BCIS). There were no significant differences between the two groups on age, sex, marital status, education, and economic status. There were significant differences in total score and emotional characteristic subscale, cognitive interpretation subscale, and physical characteristic subscale of auditory hallucination scales in between the two groups. Correlation between BCIS-total and total auditory hallucinations score was negative (Spearman Rho −0.319; P < 0.05). Hallucinating patients, more in nonaffective group, described a negative impact of hallucinating voices along with emotional consequences on their lives which lead to distress and disruption.
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40
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Papadopoulos C, Foster J, Caldwell K. 'Individualism-collectivism' as an explanatory device for mental illness stigma. Community Ment Health J 2013; 49:270-80. [PMID: 22837106 DOI: 10.1007/s10597-012-9534-x] [Citation(s) in RCA: 73] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2011] [Accepted: 07/14/2012] [Indexed: 10/28/2022]
Abstract
The aim of this study is investigate whether the cross-cultural value paradigm 'individualism-collectivism' is a useful explanatory model for mental illness stigma on a cultural level. Using snowball sampling, a quantitative questionnaire survey of 305 individuals from four UK-based cultural groups (white-English, American, Greek/Greek Cypriot, and Chinese) was carried out. The questionnaire included the 'Community Attitudes to Mental Illness scale' and the 'vertical-horizontal individualism-collectivism scale'. The results revealed that the more stigmatizing a culture's mental illness attitudes are, the more likely collectivism effectively explains these attitudes. In contrast, the more positive a culture's mental illness attitudes, the more likely individualism effectively explains attitudes. We conclude that a consideration of the individualism-collectivism paradigm should be included in any future research aiming to provide a holistic understanding of the causes of mental illness stigma, particularly when the cultures stigmatization levels are particularly high or low.
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Affiliation(s)
- Chris Papadopoulos
- Institute for Health Research, University of Bedfordshire, Putteridge Bury, Hitchin Road, Bedfordshire, LU2 8LE, UK.
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41
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Rashed MA. Psychiatric judgments across cultural contexts: relativist, clinical-ethnographic, and universalist-scientific perspectives. THE JOURNAL OF MEDICINE AND PHILOSOPHY 2013; 38:128-48. [PMID: 23459177 DOI: 10.1093/jmp/jht003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Psychiatrists encounter persons from diverse cultures who profess experiences (e.g., communicating with spirits) that evoke intuitions of abnormality. This view might not be shared with the person or her/his cultural peers, raising questions concerning the justification of such intuitions. This article explores three positions relevant to the process of justification. The relativist position transfers powers of judgment to the subject's peers yet neglects individual values and operates with a discredited holistic view of culture. The clinical-ethnographic position remedies this by suspending judgment subject to understanding the individual in a sociocultural context yet finds objections with the universalist-scientific position: objective standards exist and could justify intuitions of abnormality cross-culturally. This article argues that the claim to objectivity is value-laden, reflecting instead a brand of normality and relationship to reality further upheld through epistemological utility and valued technological progress. In conclusion, it is suggested that the clinical-ethnographic position takes personal values and context seriously, both of which are crucial for responsible clinical practice.
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Aklin WM, Turner SM. Toward understanding ethnic and cultural factors in the interviewing process. ACTA ACUST UNITED AC 2012; 43:50-64. [PMID: 22121959 DOI: 10.1037/0033-3204.43.1.50] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
The clinical interview is critical in the diagnostic assessment undertaking in clinical settings, and cultural/ethnic influences have been shown to influence the outcome of this process. Specifically, a number of studies have reported that proportionally far more ethnic minorities than Caucasians are likely to be misdiagnosed when assessed for psychiatric disorders. This particularly is the case when open clinical interviews are used. Semistructured interviews, on the other hand, result in an increase in diagnostic accuracy with ethnic minorities. Parameters associated with bias in the clinical interview of ethnic minorities and its impact on assessment, diagnosis, and treatment decisions are examined. Although the current discussion focuses primarily on African Americans, many examples are provided that pertain to other ethnic groups. Strategies for addressing these issues are explored and recommendations for increasing cultural competence are made. (PsycINFO Database Record (c) 2011 APA, all rights reserved).
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Affiliation(s)
- Will M Aklin
- Department of Psychology, University of Maryland, College Park
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Abstract
Over the past 50 years, schizophrenia as a disorder has been widely studied across cultures throughout the world. There are differences not only in the symptoms and presentation but also in outcome and prognosis. Various authors have tried to explore and explain such variation but the reasons for this are not always clear. In this paper, we review some of the cultural aspects of schizophrenia.
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Affiliation(s)
- Gurvinder Kalra
- Department of Psychiatry, Lokmanya Tilak Medical College and Sion Hospital, Sion, Mumbai, India
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Kizilhan JI. Changes in Disease Perception, Coping Strategies and Diagnoses in the Case of First and Fourth Generations of Turkish Migrants in Germany. EUROPES JOURNAL OF PSYCHOLOGY 2012. [DOI: 10.5964/ejop.v8i3.473] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Diederen KMJ, van Lutterveld R, Sommer IEC. Neuroimaging of voice hearing in non-psychotic individuals: a mini review. Front Hum Neurosci 2012; 6:111. [PMID: 22582042 PMCID: PMC3348719 DOI: 10.3389/fnhum.2012.00111] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2011] [Accepted: 04/12/2012] [Indexed: 11/23/2022] Open
Abstract
Auditory verbal hallucinations (AVH) or “voices” are a characteristic symptom of schizophrenia, but can also be observed in healthy individuals in the general population. As these non-psychotic individuals experience AVH in the absence of other psychiatric symptoms and medication-use they provide an excellent model to study AVH in isolation. Indeed a number of studies used this approach and investigated brain structure and function in non-psychotic individuals with AVH. These studies showed that increased sensitivity of auditory areas to auditory stimulation and aberrant connectivity of language production and perception areas is associated with AVH. This is in concordance with investigations that observed prominent activation of these areas during the state of AVH. Moreover, while effortful attention appears not to be related to AVH, individuals prone to hallucinate seem to have an enhanced attention bias to auditory stimuli which may stem from aberrant activation of the anterior cingulated regions. Furthermore, it was observed that decreased cerebral dominance for language and dopamine dysfunction, which are consistently found in schizophrenia, are most likely not specifically related to AVH as these abnormalities were absent in healthy voice hearers. Finally, specific aspects of AVH such as voluntary control may be related to the timing of the supplementary motor area and language areas in the experience of AVH.
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Affiliation(s)
- Kelly Maria Johanna Diederen
- Neuroscience Division, Rudolf Magnus Institute for Neuroscience, University Medical Center Utrecht Utrecht, Netherlands
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Abstract
Hallucinations are a vivid illustration of the way culture affects our most fundamental mental experience and the way that mind is shaped both by cultural invitation and by biological constraint. The anthropological evidence suggests that there are three patterns of hallucinations: experiences in which hallucinations are rare, brief, and not distressing; hallucinations that are frequent, extended, and distressing; and hallucinations that are frequent but not distressing. The ethnographic evidence also suggests that hallucinations are shaped by learning in at least two ways. People acquire specific representations about mind from their local social world, and people (particularly in spiritual pursuits) are encouraged to train their minds (or focus their attention) in specific ways. These two kinds of learning can affect even perception, this most basic domain of mental experience. This learning-centered approach may eventually have something to teach us about the pathways and trajectories of psychotic illness.
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Affiliation(s)
- T. M. Luhrmann
- Department of Anthropology, Stanford University, Stanford, California 94305-2145
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Abstract
The incidence of psychotic disorders is extremely high in several immigrant groups in Europe. This article describes the epidemiological evidence for increased incidence rates among immigrants compared with nonimmigrant populations and explores possible explanations for this excess risk. Potential causes not only involve factors acting at the level of the individual, but encompass the broader social context of neighborhoods and ethnic groups. Growing up and living in a disadvantaged ethnic minority position, characterized by a low social status, high degree of discrimination against the group and low neighborhood ethnic density, may lead to an increased risk of psychotic disorders, especially when individuals reject their minority status and when their social resources are insufficient to buffer the impact of adverse social experiences. Future research should refine measures of the social context, adopt a life-course perspective and should integrate social and neurobiological pathways.
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Affiliation(s)
- Wim Veling
- Center for Early Psychosis, Parnassia Psychiatric Institute, The Hague, The Netherlands
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Abdullah T, Brown TL. Mental illness stigma and ethnocultural beliefs, values, and norms: an integrative review. Clin Psychol Rev 2011; 31:934-48. [PMID: 21683671 DOI: 10.1016/j.cpr.2011.05.003] [Citation(s) in RCA: 283] [Impact Index Per Article: 21.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2010] [Revised: 05/23/2011] [Accepted: 05/24/2011] [Indexed: 11/17/2022]
Abstract
The current literature on the problem of mental illness stigma in the United States must be expanded to better account for the role of culture. This article examines the relationship between mental illness stigma and culture for Americans of American Indian, Asian, African, Latino, Middle Eastern, and European descent. In this review, culture refers to the shared beliefs, values, and norms of a given racial or ethnic group. The reviewed literature indicates that there are differences in stigma among the various cultural groups; however, explanations as to why these differences exist are scant. Qualitative and quantitative studies indicate that cultural values are important with regard to stigma, particularly for Asian Americans and African Americans. Less is known about the interaction between cultural values and mental illness stigma for other cultural groups. Continued research in the area requires better organization and more exploration of the role of cultural history and values as they relate to mental illness stigma. To that end, a detailed, systematic approach to future research in the area is proposed.
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Affiliation(s)
- Tahirah Abdullah
- Department of Psychology, University of Kentucky, Lexington, KY 40506-0044, USA.
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Culture and the prevalence of hallucinations in schizophrenia. Compr Psychiatry 2011; 52:319-25. [PMID: 21497227 DOI: 10.1016/j.comppsych.2010.06.008] [Citation(s) in RCA: 112] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2009] [Revised: 05/31/2010] [Accepted: 06/21/2010] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE Besides demographic, clinical, familial, and biographical factors, culture and ethnicity may plausibly influence the manifestation of hallucinations. The purpose of this study was to investigate the influence of culture on the frequency of different kinds of hallucinations in schizophrenia. METHOD Patients with a clinical diagnosis of schizophrenia were diagnosed by means of the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition criteria. Seven independent samples were consecutively recruited in Austria, Lithuania, Poland, Georgia, Ghana, Nigeria, and Pakistan using identical inclusion/exclusion criteria and assessment procedures (N = 1080 patients total). The association of key demographic factors (sex and age), clinical factors (age at onset and duration of illness), and country of origin with hallucinations of different kinds was examined. RESULTS The prevalence of various kinds of hallucinations was substantially different in the samples; however, the rank order of their occurrence was similar. Auditory hallucinations were relatively infrequent in Austria and Georgia and more prevalent in patients with an early age at onset of disease. Visual hallucinations were more frequently reported by the West African patients compared with subjects from the other 5 countries. Cenesthetic hallucinations were most prevalent in Ghana and in patients with a long duration of illness. CONCLUSION We hypothesize that the prevalence of the different kinds of hallucinations in schizophrenia is the result of the interaction of a variety of factors like cultural patterns as well as clinical parameters. According to our study, culture seems to play a decisive role and should be taken into account to a greater extent in considerations concerning the pathogenesis of psychotic symptoms.
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