The relationship between shame and perceived biological origins of mental illness among South Asian and white American young adults

Mental illness (MI) affects one in four people in their lifetime and a failure to seek help for MI can have grave consequences. To decrease stigma and increase help seeking, prior campaigns have promoted the biological origins of MI. Even though some research supports the efficacy of this approach, other research does not. We propose cultural differences as a partial explanation for these inconsistent results. The current study assessed ethnic differences in the relationship between perceived causes of MI, shame associated with MI and perceived family support for help seeking. White and South Asian American (SAA) undergraduate students completed an online survey (n = 177). Results indicated that SAAs were significantly more likely than whites to perceive character deficits as the cause of MI. Further, among those who had sought help for MI, ethnic differences emerged in perceptions of MI based on perceived cause. SAAs who believed that MI had biological origins perceived more shame and less family support for seeking help compared to SAAs who believed MI was due to character deficits. The converse was true for whites – those who believed that MI had biological origins perceived less shame and more family support for help seeking compared to whites who believed MI was due to character deficits. The results of the current study illuminate the role that culture plays in perceptions of MI. Further, these results have implications for interventions targeting South Asian populations and for mental health outreach in general.     

Stigma towards psychosis: Cross‐cultural differences in prejudice,stereotypes, and discrimination in White British and South Asians

Public stigma towards people with mental health problems has been demonstrated in Western societies. Little is known about non‐Western cultures and whether cultures differ in their perceptions of people with mental health problems. Aim of this study was to examine cultural differences in prejudice, stereotypes, and discrimination towards people with psychosis. Participants were from White British and South Asian backgrounds (N = 128, aged 16–20 years) recruited from two schools and colleges in the United Kingdom. They completed a cross‐sectional survey on affective, cognitive, and behavioural dimensions of stigma. Results revealed significant cultural differences on all three stigma dimensions. South Asians attributed higher anger (prejudice) and dangerousness (stereotypes) to people with psychosis than White British. They also reported lower willingness to help, greater avoidance, and higher endorsement of segregation (discrimination). The effects of ethnic group on helping intentions, avoidance, and segregation endorsement were mediated by anger and by dangerousness. Understanding cultural differences in stigma towards psychosis will be important for designing stigma interventions as well as treatments for people with different cultural backgrounds.     

South African Muslim Psychologists' Perceptions of Mental Illness

This study explored perceptions of mental illness in a sample of 10 female Muslim psychologists in a South African city to determine the influences of religion (and Islam specifically) on their understanding of the aetiology and treatment of mental illness. Participants responded to a semi-structured interview. The data from the interviews were thematically analyzed. Four themes emerged from the analysis: mental illness as maladaptive coping, religion as a resource for wellbeing, influences of personal religiosity on therapy and openness to collaborative treatment     

Carers of adults with mental illness: Comparison of respite care users and non‐users

The aim of this study was to investigate the rate, type and duration of respite care use in carers of an adult with mental illness, and the differences between respite care users and non‐users on demographic, caregiving context and adjustment variables. A total of 106 carers completed a postal survey questionnaire. The majority (76%) of carers who accessed care used it weekly, fortnightly or monthly. The most common types of respite services were in‐home, day programs, and residential respite. The mean duration of respite care periods was 58.18 hr each time respite was used. Compared to respite care non‐users, carers who accessed respite care were more likely to live with their care‐recipient and provide more caregiving. They also reported more benefits associated with their caregiving. Findings suggest that respite care services need to be varied, available for carers on a weekly to monthly basis with a range in duration, but catering for higher use of 2‐day respite periods. Carers who are highly engaged in a range of caregiving tasks and who live with their care recipient are more likely to have a greater need for respite care. Future research should examine the effects of a range of respite care factors on carer adjustment outcomes.     

Imagined contact and mental illness stigma in an Asian context: Bolstering the effect and examining the impact of factual information

Imagined contact can be effective at reducing social stigma. However, the effect may depend on the strength of the stigma held. We tested the robustness of imagined contact in an Asian setting where stigmatization of mental illness is stronger than in Western countries. In Experiment 1 (n = 167) with five conditions, only an enhanced version of positive imagined contact was able to decrease stigma towards people with schizophrenia through decreasing intergroup anxiety. Given the potential discrepancy between imaginations and reality about experiences with stigmatized groups, in Experiment 2 (n = 121), we tested the hypothesis that after presenting participants with factual information about a mental illness group, imagined contact might backfire, resulting in more negative perceptions. However, enhanced imagined contact alongside factual message about schizophrenia did not increase stigma. The backfiring hypothesis was therefore not supported. Nevertheless, providing realistic information did negate the positive effects of enhanced imagined contact on stigma reduction. In both experiments, we also showed that intergroup anxiety mediated the effect of enhanced imagined contact on various measures of stigma.     

Mental illness,religion, and the rational mind: The case of Clifford W. Beers

This article focuses on the mental illness of Clifford W. Beers, who pioneered mental hospital reform in the United States in the early decades of the twentieth century, and the encouragement Beers received from William James in this endeavor. It argues that James supported Beers because he personally identified with the younger man's struggles with mental illness and with the high value that he placed on the vital importance of the rational mind in regaining one's sanity.     

Aggression in British heterosexual relationships: A descriptive analysis

A 12-item scale, derived from the Conflict Tactics Scale, was administered to a representative sample of 1,978 heterosexual men and women in Great Britain in mid November 1994. Men and women were asked to identify conflict tactics sustained or inflicted in all past and present relationships and those sustained in current relationships. This paper reports results for physical victimization and also reports on two further questions asked to discern context and meaning ascribed to such sustained or inflicted victimization. Both sexes reported having experienced physical victimization with a higher percentage of men sustaining victimization, mainly as a result of minor acts of assault. Almost equal percentages of men and women reported inflicting victimization against partners. Additionally, incidence of physical victimization is presented according to relationship status, age, socioeconomic category, and by regional distribution. Both sexes reported a range of reasons or contexts ascribed to their sustained or inflicted victimization. © 1996 Wiley-Liss, Inc.     

Gender Differences in Reactions to Mental Illness Labeling: The Role of Agency and Communion

Numerous individual characteristics influence responses to receiving a mental health diagnosis, including gender. This study sought to determine how gender influences reactions to being labeled as depressed or not depressed, which were categorized as falling into themes of communion or agency. Using the themes developed by Niedzwienska (2003), 168 college students’ responses to depression labels were coded as a part of a laboratory experiment. The results indicate that the expected sex differences do exist, but multivariate analyses indicate that the choice of communal themes was influenced by sex but the use of agency themes was not influenced by sex.     

Career counsellors and suicide risk assessment

ABSTRACT

Recent discussions suggest that career counsellors need to be trained in more holistic frameworks in order to deal with the career and psychological issues of their clients. In particular, research shows a strong connection between employment and suicidality, including changes in socioeconomic status, disruption in employment, sudden unemployment, learning disabilities, occupational stress, difficulties at work and interpersonal conflicts. Many people struggling with work-related issues are likely to suffer from anxiety, depression, isolation or substance misuse, all significant risk factors associated with suicidal ideation. Therefore, by becoming competent in dealing with both vocational and personal issues, career counsellors might be in a unique position to be effective in assessing suicidal risk due to their less stigmatised role in the field.     

19世纪西方医学对精神疾病诊治的影响

精神疾病是现代困扰人类的主要疾病之一。通过总结19世纪西方医学对精神疾病的认识及主要治疗方法,拟展现这个世纪中治疗方法随观念变化和实践深入而发展的轨迹,旨在说明19世纪是西医精神病学发展史上的重要时期,并揭示其与现代精神疾病治疗的历史传承性。     

大陆和台湾地区精神疾病患者强制住院医疗之比较研究

精神病患者是社会弱势群体,其权利易遭受他人的侵害,同时其有可能对他人权利造成损害。因此为维护本人和他人权利,有必要对其实施特殊的措施。大陆和台湾地区均规定对严重精神病患者实施强制住院医疗措施,但二者在强制医疗的对象、程序以及人身自由的限制等方面存在重大差异。大陆强制医疗采取的是行政程序,而台湾地区是"准司法程序",其强制医疗决定由第三方作出。台湾地区精神卫生法为精神病患者提供了较为完善的权益保障体系。     

Ethical Challenges and Legal Issues for Mental Health Professionals Working With Family Caregivers of Individuals With Serious Mental Illness

Mental health professionals frequently work with family caregivers in the provision of psychotherapy services to individuals with serious mental illness. To address the need for ethical guidelines for working with family caregivers, an analysis of relevant ethical and legal issues is provided within the context of dynamic mental health care and legal systems. When working with family caregivers, practitioners utilize the American Psychological Association’s Ethics Code (2010), legal codes, and a complex decision-making plan; identify and communicate ethical obligations to family caregivers; consider the unmet needs of this population; avoid harm resulting from multiple relationships; and balance ethical duties of beneficence and respect for autonomy.     

Occupational Therapy Interventions in Mental Health: A Literature Review in Search of Evidence

A growing body of literature sheds light on occupational therapy (OT) interventions and outcomes in adult mental health. Although this research has not developed to the point where a systematic review is warranted, a synthesis of these findings is needed. This article provides an overview of OT interventions in adult mental health and their documented outcomes. Fifty peer-reviewed intervention studies targeting adults with mental illness were reviewed. Seven categories of interventions emerged: employment/education; psychoeducation; creative occupations/activity; time use/occupational balance; skills/habit development; group/family approaches; and animal-assisted therapy. Further research involving rigorous designs is needed to establish a solid evidence base for OT interventions in adult mental health.     

Multiple illness perceptions in older adults: Effects on physical functioning and medication adherence

Objective: Previous research on illness perceptions has focused on single illnesses, but most adults over 65 suffer from multiple illnesses (multimorbidity). This study tests three competing operationalisations of multiple illness perceptions in predicting physical functioning and adherence: (1) main effects and interactions model; (2) peak model with effects of the most prominent illness perception; and (3) combined model with averaged illness perceptions over multiple illnesses.

Design: Longitudinal study in N?=?215 individuals (65–86?years) with multimorbidity at two measurement points over six months. Participants filled in two Brief Illness Perception Questionnaires (B-IPQ) on their two most severe illnesses.

Main outcome measures: Physical functioning, medication adherence.

Results: Factor analyses suggest that the B-IPQ contains three dimensions; consequences, control and timeline. Multiple regression models fit the data best for (1) and (3). Timeline (β?=??.18) and control (β?=?.21) predict adherence in (1); consequences (β?=?.16) and control (β?=?.20) in (3). Physical functioning was significantly predicted by interacting control beliefs in (1; β?=?.13), by peak consequences in (2; β?=??.14) and by consequences (β?=??.15) in (3).

Conclusions: Individuals with multimorbidity hold both distinct and combined perceptions about their illnesses. To understand individual responses to multimorbidity, perceptions about all illnesses and multimorbidity as entity should be examined.     

Internalized transphobia and mental health among transgender adults: A nationwide cross-sectional survey in South Korea

Abstract

Introduction: Transgender people are stigmatized in South Korea (hereafter Korea), where cultural expectations of a biologically-based, binary sex and gender system present fundamental challenges to those whose gender identity does not align with their birth-assigned sex. A growing international body of literature implicates gender minority stress as a key contributor to transgender mental health disparities, but little research has been conducted on this topic in Korea. As in other cultural settings, depression and suicidality are urgent public health concerns for transgender people in Korea, primarily for those who have not initiated gender affirming medical treatment (GAMT), such as cross-sex hormone therapy. In the current study, an international and interdisciplinary team of authors apply the lens of gender minority stress to elucidate the relationships between a key facet of gender minority stress, internalized transphobia (ITP), and outcomes of depressive symptoms and suicidality.

Methods: Based on a cross-sectional survey of 207 Korean transgender adults, the current study evaluates the relationships between ITP and depressive symptoms, suicidal ideation, and suicide attempts. ITP was measured with an eight-item, Korean-language questionnaire adapted from the Gender Minority Stress and Resilience Measure through a translation and back-translation process.

Results: Korean trans women and trans men mean (mean age?=?26.4) were included in the analysis, most of whom had at least one experience of any GAMT. The findings of this study show that Korean transgender adults face similar public health concerns such as high prevalence of depressive symptoms, suicidal ideation, and suicide attempts. As predicted, ITP was significantly related to depressive symptoms, suicidal ideation, and suicide attempts.

Conclusion: The authors suggest potential clinical, policy, and research applications, including institutional interventions, to address structural and cultural barriers to optimal mental health and GAMT as well as mental health interventions to reduce Korean transgender people’s internalized negative beliefs about their gender identity.