Barnow / Balkir Cultural Variations in Psychopathology

From Research to Practice
1. Auflage 2013
ISBN: 978-1-61676-434-0
Verlag: Hogrefe Publishing
Format: PDF
Kopierschutz: 1 - PDF Watermark

E-Book, Englisch, 299 Seiten

Improving mental health care through culturally sensitive research and practice
Culturally sensitive practice is a vital component of effective mental health care in our increasingly diverse societies: Mental illnesses vary in prevalence between cultural and ethnic groups, as do the meanings attached to them and people's responses to them.

The important implications of this interplay between culture and psychopathology for diagnosis and treatment are scrutinized and elucidated in this comprehensive and well-organized book, which uniquely looks at a range of practical examples involving various ethnic minority populations in North America and Europe. Leading experts from around the world have integrated divergent topics into a systematic and clinically relevant volume.

Cultural Variations in Psychopathology: From Research to Practice is an important resource for researchers and in particular for any mental health professional who works with ethnically diverse communities.

Autoren/Hrsg.

Barnow, Sven

Balkir, Nazli

Fachgebiete

• Sozialwissenschaften Psychologie Psychotherapie / Klinische Psychologie Psychopathologie
• Medizin | Veterinärmedizin Medizin | Public Health | Pharmazie | Zahnmedizin Medizinische Fachgebiete Psychiatrie, Sozialpsychiatrie, Suchttherapie
• Sozialwissenschaften Psychologie Allgemeine Psychologie Sozialpsychologie Kulturpsychologie, Ethnopsychologie

Inhaltsverzeichnis

1;Foreword;6
2;Preface & Acknowledgments;7
3;Table of Contents;8
4;I. Introduction: The Relevance of Culture for Mental Health and Illness;10
4.1;Introduction;12
4.2;1 Migration and Mental Health;17
5;II. How Culture Shapes Our Brain;34
5.1;2 Understanding the Self;36
5.2;3 The Self and Its Emotional Brain;52
6;III. The Interplay Between Culture and Emotion Regulation;74
6.1;4 Socialization of Emotions and Emotion Regulation in Cultural Context;76
6.2;5 Emotion Regulation in Cultural Context;102
6.3;6 Unpacking Cultural Differences in Emotion Regulation;124
7;IV. Diagnosis;144
7.1;7 Culturally Informing Diagnostic Systems;146
7.2;8 Depression and “Somatization” Among Two Divergent Cultural Groups;163
7.3;9 Cultural Influences on Perceptions of Pain;182
7.4;10 Embitterment in Cultural Contexts;193
7.5;11 Suicide in Cultural Context;207
7.6;12 Substance Abuse and Addiction Among Divergent Ethnic Groups;215
7.7;13 Possible Misclassification of Psychotic Symptoms Among Moroccan Immigrants in The Netherlands;228
8;V. Treatment;240
8.1;14 Mental Illness Models and Help-Seeking Behaviors Among Turkish Immigrant Patients in Europe;242
8.2;15 Training for Overcoming HealthDisparities in Mental Health Care;257
8.3;16 Integration of Immigrants in Psychiatry and Psychotherapy;279
9;Keyword Index;292
10;Contributors;293

Leseproben

Migration and Suicidality

The major risk factors for suicide are described as potentially modifiable and nonchangeable factors. Gender, age, ethnicity, sexual orientation, and previous suicide attempts belong to the nonchangeable factors while access to methods, history or presence of a psychiatric disorder or a physical illness, social isolation, unemployment, anxiety, hopelessness, and reduced life satisfaction, most of which are associated with immigrant status as well, are placed under the rubric of potentially modifiable risk factors (Berltolote, 2004). Furthermore, it has also been revealed that suicide risk increases in the 10 years following migration (Kwan & Ip, 2007) if the age at migration was less than 12 years (Peña et al., 2008; Borges, Nock, Medina-Mora, Hwang, & Kessler, 2009) and with the frequency of residential changes (Ott, Winkler, Kyobutungi, Laki, & Becher, 2008). Studies demonstrated substantial differences in suicidal ideation and suicidal behavior between immigrant groups. Whereas some studies have reported lower risk for suicide among some ethnic minority groups compared to majority population (Razum, Zeeb, Akgün, & Yilmaz, 1998; Razum, Zeeb, & Rohrmann, 2000; Razum & Swamy, 2001; Razum & Zeeb, 2004), other studies revealed that some ethnic groups exhibit higher suicide rates than those found in their countries of origin and in the host country into which they have immigrated (Garssen, Hoogenboezem & Kerkhof, 2006). Likewise, data of the mortality statistics from 1980 to 1997 in Germany revealed lower suicide rates in immigrants than in Germans (relative risk: 0.3). However, the group of young Turkish women shared out of line with a rate twice as high compared to sameaged native women (relative risk: 1.8) (Razum & Zeeb, 2004). In comparison to this, the suicide rates in Turkey were much lower than in immigrants of Turkish origin in Germany, which can be explained by the social coherence in the Turkish society (Sayil, 1997). Furthermore, it has been revealed that the higher rate of suicides in young Turkish immigrant woman is moderated by family conflict, which appears to be a precipitating factor. This family conflict might be due to an intergenerational culture conflict when those young women start to individuate. Likewise, another study demonstrated that the rate of suicide attempts in Turkish female immigrants who were treated in a psychiatric hospital increased by the factor 3.02 compared to the rate of German female patients (32.2% Turkish immigrants) (Grube, 2004). Another study on suicide attempts of Turkish immigrants in emergency rooms revealed that the group with the highest risk to attempt suicide is the second generation (Yilmaz & Riecher-Rössler, 2008; van Bergen, Smit, van Balkom, van Ameijden, & Saharso, 2008; Peña et al., 2008; Borges et al., 2009; Fortuna, Perez, Caninco, Sribney, & Alegria, 2007). In the Netherlands young immigrant women of South Asian, Turkish, and Moroccan origins demonstrated disproportionate rates of nonfatal suicidal behavior. For instance, van Bergen et al. (2008) collected data on suicidal behavior and ideation among female Turkish immigrants (aged 16–24), who had significantly more suicidal ideation (38.1%) compared to Dutch girls of the same age (17.9%) and compared to the same-aged Moroccan girls (12.8%). In a similar study, van Bergen et al. (2010) found that rates of attempted suicide among Turkish and South Asian-Surinamese young women were higher than that of Dutch females, while Moroccan females had lower rates than Dutch female adolescents. The authors pointed out that physical and sexual abuse and an impaired family environment, as well as parental psychopathology or parental substance abuse, contributed to nonfatal suicidal behavior of females across ethnicities. These risk factors, as well as low social economic class and level of education, did not fully explain the vulnerability of Turkish and South Asian-Surinamese females (van Bergen et al., 2008, van Bergen et al., 2010). The analysis of van Bergen et al. (2010) included a comparison of class factors as well as psychiatric and psychological risk factors. In at least half of the cases, South Asian, Turkish, and Moroccan women experienced specific stressful life events related to their family honor. Although these findings can be incorporated into strategies for prevention, the origins of ethnic disparities in suicidal behavior deserve further examination.

Migration and Psychosis

A growing body of evidence suggests that migration is a risk factor for the development of schizophrenia, although the putative mechanism remains unclear. Several European studies indicated a higher prevalence of schizophrenia and schizophrenia spectrum disorders among ethnic minority groups. For instance, in a 3–center, prospective study of firstonset psychotic syndromes over a 2–year period, Kirkbride et al. (2006) and Fearon et al. (2006) reported that psychoses were more common among ethnic minority groups, and that African Caribbeans and Black Africans in the UK were at an especially high risk of schizophrenia and mania. They described a significant and independent variation in the incidence of schizophrenia and other forms of psychoses in terms of gender, age, ethnicity, and place of residence. Further, these authors also hypothesized that environmental effects may interact with genetic and other factors in the etiology of psychosis. Likewise, Sharpley, Hutchington, McKenzie, & Murray (2001) revealed that the African Caribbean population in England is at increased risk of both schizophrenia and mania. According to the authors, these patients show more affective symptoms and a more relapsing course with greater social disruption, but fewer negative symptoms than the native English patients. Studies from the Netherlands have also demonstrated an excess of schizophrenia in immigrants, with particularly high rates in people of Surinamese, Moroccan, and Antilles origin (Selen et al., 2001; Veling et al., 2006). A Danish study also provided an evidence for high incidence of psychotic disorders among immigrants from Australia, Africa, and Greenland (Cantor-Graae, Pedersen, McNeil, & Mortensen, 2003). Likewise, Fossion et al. (2002) observed that Moroccan immigrants were significantly more likely to be diagnosed with psychoses than a Belgian comparison group. In a meta-analysis of Cantor-Graae & Selten (2005) moderate relative risk for schizophrenia 2.7 (95% CI = 2.3–3–2) was found in first-generation immigrants; however, this rate was higher in second generation 4.5 (95% CI = 1.5–13.1) immigrants. This increased risk for schizophrenia found among second-generation migrants suggests that selection hypothesis can be rejected as the sole explanation for the findings on migrants. Furthermore, the greatest relative risk for schizophrenia was seen among immigrants from developing countries (relative risk = 3.3, 95% CI = 2.8–3.9) and immigrants from countries where the majority of the population is black (relative risk = 4.8, 95% CI = 3.7–6.2), respectively. The finding concerning the greater effect size associated with black skin color may suggest that migrants whose skin color is considerably darker than the background population may share a common risk exposure, such as experience of discrimination. Similarly, Igel, Brähler, and Grande (2010) reported that discrimination determines mental and physical health of immigrants, highlighting the importance of taking experiences of discrimination into account as a psychosocial stressor. In the same sense, it was revealed that ethnic density – that is, the density of the same ethnic group around an individual – plays a significant role in genesis and maintenance of psychotic disorders among ethnic minority groups (Boydell, van Os, & McKenzie, 2001; Faris & Denham, 1960). Social support and lower rates of long-term experience of social defeat (i.e., the chronic stressful experience of outsider status in an ethnically dense environment) may act as protective factors in the beginning and relapse of psychotic disorders in individuals who have a (genetic) predisposition for the illness. Similarly, Bhugra (2005) postulated that cultural congruity, when people with similar cultural values live close to one another, might be more important in this respect. However, further work is needed to map cultural congruity and ethnic density with epidemiological data (Bhugra et al., 2011).