Attribution and serious mental illness: understanding multiple perspectives and ethnocultural factors.

Attributions regarding the nature, cause, and best treatment of mental health problems were examined in a total of 563 adults with serious mental illness from four ethnocultural groups, 185 family members, and 43 mental health practitioners. Attributions agreed in many areas, such as stress as a cause, and medical intervention and counseling as best treatment. Differences were found between the practitioner and other groups in attributions regarding the senses in the nature of mental illness, and in drugs and alcohol as a cause. The role of ethnicity was examined and treatment implications discussed.

Recovery from psychotic illness: a 15- and 25-year international follow-up study.

BACKGROUND: Poorly defined cohorts and weak study designs have hampered cross-cultural comparisons of course and outcome in schizophrenia. AIMS: To describe long-term outcome in 18 diverse treated incidence and prevalence cohorts. To compare mortality, 15- and 25-year illness trajectory and the predictive strength of selected baseline and short-term course variables. METHODS: Historic prospective study. Standardised assessments of course and outcome. RESULTS: About 75% traced. About 50% of surviving cases had favourable outcomes, but there was marked heterogeneity across geographic centres. In regression models, early (2-year) course patterns were the strongest predictor of 15-year outcome, but recovery varied by location; 16% of early unremitting cases achieved late-phase recovery. CONCLUSIONS: A significant proportion of treated incident cases of schizophrenia achieve favourable long-term outcome. Sociocultural conditions appear to modify long-term course. Early intervention programmes focused on social as well as pharmacological treatments may realise longer-term gains.

Urbanization, mental health, and social deviancy. A review of issues and research.

This article reviews the international research literature on the relationship of urbanization, mental health, and social deviancy. Attention is called to the multidisciplinary and multisectoral nature of the topic, and to its associated definitional, conceptual, and methodological issues and challenges. Selected research literature on rural-urban differences in mental health and social deviancy is reviewed. There is little consensus on the causal relationship between urbanization, mental health, and social deviancy, although numerous environmental and social pathogenic processes have been posited and investigated. Data indicate rural and urban milieus can have both pernicious and salutary consequences and that more research is needed to specify critical etiological factors and their relationship to subpopulation characteristics. Suggestions for improving future research efforts are offered, including the use of more complex theoretical models, measurement indices, and data analysis procedures.

Counseling and psychotherapy with Japanese Americans: cross-cultural considerations.

The literature of the past two decades on Japanese-American culture, behavior, and mental health services and issues is reviewed. Counseling and psychotherapy with these clients are then discussed, taking into account traditional Japanese cultural values, with particular emphasis on verbal and nonverbal factors affecting therapeutic approaches and communication.

International consultation and the homogenization of psychiatry in Southeast Asia.

The nature of psychiatric care varies little among the capital cities of Southeast Asia. Differences that may exist are of degrees along a common dimension. Colonial forces from the past and contemporary diffusion of modern psychiatry have produced this remarkably uniform pattern of thought and treatment across divergent national and cultural boundaries. Our paper analyzes the homogenization of psychiatry in Southeast Asia in three ways. First, we examine international mental health education, consultation and collaboration as interlocking mechanisms for the transfer of psychiatric technology. Second, the indirect and undesirable consequences of the diffusion of psychiatric knowledge and practice are analyzed. Third, we pose recommendations for countering these unanticipated consequences through evaluation research, ethical guidelines, and educational and intervention practices that strengthen indigenous healing resources.

Cross-cultural research on severe mental disorders: issues and findings.

The present paper will review and discuss research issues and findings of recent cross-cultural studies of severe mental disorders. The paper is divided into two main sections. The first section will discuss: (1) the concept of culture, (2) hierarchical levels of human behavior determinants, (3) the cultural variability continuum, and (4) the concept of self. The second section will discuss: (1) epidemiology, (2) culture and clinical phenomenology in severe disorders, and (3) culture as an etiological determinant. The paper closes with a discussion of some conclusions and suggestions for future research.

Stress, social supports, and schizophrenic disorders: toward an interactional model.

The present article proposes an interactional model of schizophrenic disorders in which three parameters of stressors (e.g. stressor category, stressor content, stressor descriptors) interact with four parameters of social networks/supports (e.g. structure, interactional properties, qualitative properties, functional indices) to produce a stress state characterized by positions along three orthogonal dimensions: overload-underload, positive-negative affect, high arousal-low arousal. The stress state, it is speculated, is reciprocally related to various clinical dimensions, functional system impairments, quantitative response parameters, and qualitative response parameters which constitute the "schizophrenic" disorder. The basic point of the model is that the formative, precipitative, expressive, and maintaining forces of schizophrenic-type disorders are influenced by the simultaneous interaction of stressors, supports, and stress states.

Depression in the wives of nuclear submarine personnel.

The authors compared levels of depression among 24 wives of nuclear submarine personnel under conditions of husband-presence and husband-absence in a crossover research design. The wives had significantly higher depression scores under conditions of husband-absence on both the Zung Depression Scale and the Multiple Affect Adjective Checklist. The results are discussed in terms of the tremendous stresses imposed on the wives as a result of the nuclear submarine deployment schedule and the failure of the Navy and the spouses to recognize and reward the wives for their efforts.

Thoughts on cross-cultural studies on the epidemiology of depression.

A considerable number of studies have been conducted on the epidemiology of depression across cultures. These studies have relied on two basic research methods: treated cases and untreated cases. However, limitations in these two methods make it impossible to arrive at any substantive conclusions about ethno-cultural variations in the rates of depression. The treated cases approach fails to control for the fact that individuals in a culture do not have equal access to psychiatric facilities nor equal motivation to psychiatric care. The untreated cases approach, which is based on community surveys, is limited by differences in the definition of depression, the diagnostic signs used to identify depression, and variations in the degree of professional contact with the potential "cases.' In addition, current cross-cultural depression studies are faced with the problems of poor diagnostic reliability for depressive disorders and profound differences in the manifestation and experience of depression among different ethno-cultural groups. Many ethno-cultural groups do not demonstrate any of the psychological components of depression associated with its presence among Western groups. An entirely new approach to the cross-cultural study of depression appears warranted. Four steps are suggested to facilitate future studies: (1) An emic determination of disorder categories in different cultures; (2) The establishment of symptom frequency, intensity, and duration baselines, (3) Objective symptom pattern determination through multivariate data processing techniques: (4) Comparative studies using similar methodologies with culturally relevant definitions of disorder.

The relationship between depression and self-concept discrepancy among different generations of Japanese-American women.

Investigated the relationship between real-ideal self-concept discrepancy and depression among different generations and age groups of Japanese-American women in Hawaii. In contrast to the numerous results with Caucasian Ss, the present findings revealed that self-concept discrepancy and depression are related positively for certain generations (i.e., Nisel, young Sansei), but not others (i.e., old Sansei, Yonsei). It was speculated that the differences were due to acculturative and historical experiences that mediated personality pattern development. The findings also point out the ethnocentricity of one of the most supported notions in Western psychology (i.e., the relationship between self-concept discrepancy and maladjustment).

Personality correlates of the Stroop Color and Word Test: more negative results.

Numerous studies have investigated personality correlates of performance on the Stroop Color and Word Test. With one exception, these studies have failed to identify any significant correlates between the two variables. The present study examined this relationship by administering the Stroop Color and Word Test, Cattell's 16 PF, and the Maudsley Personality Inventory to a sample of 210 college students. Results indicated no significant correlates existed between five different measures of Stroop Color and Word Test performance and the personality scales. It was concluded that the Stroop Color and Word Test has little relationship to measures of personality and may best be understood in terms of specific cognitive processes.

Conformity and psychopathology: a comparative study of conformity behaviors in manic-depressive, paranoid schizophrenic and normal populations.

Several theorists have speculated that schizophrenia constitutes a disorder in which there is minimal motivation to conform to social pressures, while manic-depressive psychoses represent disorders in which there is maximal motivation to conform to social pressures. However, there have been few experimental tests of these speculations, and those that have been conducted generally have yielded conflicting results because of methodological inconsistencies and limitations. The present investigation examined conformity behavior of male and female manic-depressives (MD), paranoid schizophrenics (PS), and normals (N) on two conformity tasks: attitude change and perceptual judgment. It was hypothesized that manic depressives would conform more than normals, who would conform more than paranoid schizophrenics (MD less than N less than PS). Results indicated that manic-depressives and normals conformed significantly more than paranoid schizophrenics, but did not differ from each other on either of the conformity tasks. Thus, the hypothesis was supported only partially. The results do not support the view that manic-depressive psychoses constitute disorders in which there is maximal motivation to conform to social pressures; however, the results do support the view that schizophrenia represents a disorder in which there is minimum motivation to conform. The results are discussed in terms of their implication for the uses of interpersonal psychotherapy forms.

Goal-striving discrepancy stress in urban Filipino men: II. Housing.

As part of a larger investigation of social/psychological stress and psychiatric adaptation in urban Manila, efforts were made to study the effects of goal-striving discrepancy stress in housing among Filipino men from different age groups and social classes. Goal-striving discrepancy stress is an organismic state characterized by tension and discomfort due to discrepancies between aspirations and achievements. Several studies have demononstrated that goal-striving discrepancy stress are asociated with psychiatric disorder. The present study focused upon the discrepancies between aspiration and achievements in housing among Filipino men. Housing constitutes one of man's basic problems in urban societies; however, in spite of the fact that housing is related to psychiatric adaptation, relatively few studies have been made of this problem. It is important to recognize that housing has numerous psychological implications for an individual. It is a symbol of social status and social acceptance and greatly influences an individual's view of himself and others. Some investigators have even suggested that housing may be construed as a symbolic representation of the mother-child relationship. For the present investigation, twelve housing characteristics considered to be important to Filipinos e. g., size, cost, location, ownership of land, etc., were derived and ninety-six Filipino males from different age groups and social classes were asked to indicate both their aspiration and their actual achievement for each of the twelve housing characteristics. Goal-striving discrepancies were obtained by subtracting the aspirational endorsements from the achievement endorsements. The discrepancy scores were then correlated with various psychiatric symptom patterns through factor analysis. Results of the investigation revealed profound social class differences in the amount of goal-striving discrepancy stress. ......