Asylum psychiatry, neurology, social work, and mental hygiene: an exploratory study in interprofessional history

The author proposes that an adequate appreciation of the American mental health movement will require, ultimately, an appreciation of the concurrent developments in the histories of related professions (e.g., asylum psychiatry, neurology, social work, and public mental health). In this exploratory review, the author demonstrates some reciprocal influences between these professions which were significant determinants for their present positions. Suggestions are offered for other needed interprofessional historical studies in this area.     

A daily diary study of mental health and community involvement outcomes for three Chinese American social identities

Approximately 100 American youths of Chinese descent participated in a 14-day diary study, completing daily reports on ethnic feelings, American feelings, ethnic community involvement, and psychological well-being. Participants were divided into 4 identity orientations (Chinese, American, bicultural, or other) and then assessed for differential patterns of mental health and community involvement. Chinese-centered identities were characterized by positive well-being and positive self-esteem. However, the American-centered and bicultural groups had well-being and self-esteem levels equal to that of the Chinese-centered group. Although the measures of menial health failed to differentiate the identity categories, both the Chinese- and bicultural-centered groups showed high involvement in Chinese culture, whereas American-centered participants were, significantly less involved.     

Depression,self-focus,and social interaction

The accuracy of depressed and nondepressed subjects' perceptions of their own and a social interactional partner's performance was investigated. Twenty depressed and twenty nondepressed college students participated in dyadic interactions and then rated their own and their partner's social behavior. The interactions were also rated by objective coders. Depressed subjects were differentiated from nondepressed subjects on several measures by both the coders and the subjects. Depressed subjects' self-ratings were correlated with the coders' ratings more often than were the nondepressives' ratings, suggesting depressives provided more accurate self-observations. Contrary to prediction, depressives were also more accurate in judging their partner's behavior. Depressives experienced heightened levels of self-focused attention, but this attentional focus did not mediate the relationship between depression level and self-accuracy. Finally, an analysis of the verbal statements suggests that performance differences between depressives and nondepressives may be a function of the quantity, rather than the quality, of the verbal production.     

Depression and somatic symptoms in Japanese and American college students: Negative mood regulation expectancies as a personality correlate

This study clarified contradictory findings regarding whether depression and somatic symptoms are associated more strongly with each other in non‐Western countries than in Western countries, by examining the relationships of the two variables with negative mood regulation expectancies (NMRE). NMRE are beliefs about one's ability to improve one's negative moods. Participants were 155 Japanese and 176 American undergraduates. They completed self‐report measures of NMRE, coping, depression and somatic symptoms. Results showed that depression significantly correlated with somatic symptoms for both men and women in both countries, and there was no cultural difference in the relationship between depression and somatic symptoms. The relationships of depression and somatic symptoms with NMRE did not differ between cultures. NMRE explained variance in depression in both countries but variance in somatic symptoms only for women in both countries. The relationship of NMRE with depression and somatic symptoms paralleled that between depression and somatic symptoms for both cultures. These results were consistent with the previous literature that found no difference between cultures. Results support the cross‐cultural validity of measuring NMRE in the context of coping and distress.     

Sense and nonsense in the social psychiatry concept

The term social psychiatry was justified when coined as a name denoting a psychiatric sub-discipline in order to promote the development of this specific aspect of psychiatric research and practice which, at the time, ran counter to established theory. At present, however, social psychiatry is in danger of becoming isolated, of developing in the boundary regions of psychiatric practice, and thus failing to fulfil its actual role of permeating psychiatry as a whole. The term social psychiatry is regarded as an expression of this isolation and should be avoided.     

The significance of social context: the case of adolescent childbearing in the African American community

The persistence of racial differences in US adolescent pregnancy and contraceptive use rates even after traditional indicators of social class (e.g., parental education, income, or occupation) are controlled suggests a need to focus on broader social contextual issues. Important dimensions of the social context neglected in traditional approaches to socioeconomic status include the level of racial discrimination in the community, the percentage of same-race high status workers, the differential incentives of Blacks and Whites to avoid adolescent childbearing, the quality of schools attended, and the ability of families to provide child supervision. In addition, studies comparing the long-term effects of adolescent childbearing have found less severe costs for Blacks than Whites. This finding suggests the salience of psychosocial factors such as individual resiliency and survival. Although amelioration of poverty must be a major emphasis of social policy aimed at preventing adolescent pregnancy, employment programs that prepare teens for low-paying or nonexistent jobs and other interventions that fail to address the broader social context of discrimination are insufficient.     

Race,social relationships,and mental health

Researchers often assume that the extent, quality, and effectiveness of personal relationships explain why African Americans have relatively good mental health despite experiencing high levels of stress. This study tests this assumption using data from the 1990–1992 National Comorbidity Survey. Few racial differences emerge in patterns of social relationships, and the nature and quality of social relationships do not explain African Americans’ resiliency on mental health. Several aspects of social relationships benefit African Americans’ mental health more than Whites’, but these moderating effects are insubstantial. Hence, the data do not support the assumption. If social relationships help explain the lack of racial differences in mental health, their nature and effects must be more adequately conceptualized.     

Problems in practice and research in social psychiatry

Notion and contents of social psychiatry are explained on the basis of own experiences and results in research. In this connection the author deals more in detail with questions of practice and research, the performance of diagnostics and therapy and the connecting elements of these partial tasks.     

Individualism and the social in early American social psychology

In this paper an attempt is made to specify the original conception of the social dimensions of cognition, emotion and behavior-and of a distinctively social psychology-that was held by early American social psychologists, but abandoned by later generations of social psychologists committed to Floyd Allport's individualistic experimental program. Two influential forms of "individualism" in the work of Floyd Allport are distinguished and detailed.     

Depression,Sociocultural Factors,and African American Women

The authors discuss depression in African American women from a sociocultural perspective, including aspects of oppression and racism that affect symptom manifestation. The authors highlight John Henryism as a coping mechanism, the history and continuing role of the African American church as a safe haven, and strategies for culturally competent practice. Los autores discuten la depresión en mujeres Afroamericanas desde una perspectiva sociocultural, incluyendo los aspectos de opresión y racismo que afectan a la manifestación de los síntomas. Los autores destacan el John Henry‐ismo como mecanismo de afrontamiento, la historia y el papel constante de la iglesia Afroamericana como refugio seguro, y las estrategias para una práctica culturalmente competente.     

The Papago Psychology Service: A community mental health program on an American Indian reservation

A community psychology service run by the Papago Indian tribe and staffed largely by Papago Indians who have been trained as mental health workers is described. This service is unique among mental health services for Indians in that the tribe has complete control of the funds for the service and sets its own policies. It was developed for a rather traditional Indian group, and the culture, the traditions, and the wishes of the Papago community were respected. Consultation with medicine men was built into the program from the start, and adaptation of mental health techniques to fit the culture is stressed. Before this clinic was established, few mental health resources were directly available to the reservation. Similar to other Indian tribes, the Papagos are economically disadvantaged, with an unemployment rate of over 50%, low educational attainment, and very high rates of alcoholism, suicide, and vehicular accidents. The topics covered are the tribe's view of health programs for its people, the present Papago community and traditional means of treatment, traditional psychotherapy adapted to Papago culture, the indigenous Papago mental health worker, and the non-Indian professional consultant.     

Thought and the social community

The anti‐Cartesian idea that a person's thoughts are not entirely fixed by what goes on inside that person's head is suggested by Hegel, and echoed in Wittgenstein and Frege. An argument for the view has recently been given by Tyler Burge. This paper claims that Burge's data can be explained better by an individualistic theory. The basic idea is that an individual's thoughts are specified analogically, in ordinary discourse, through the model of a language. Though the modelling‐sentences are public, the thoughts of the individual are inner states whose identity does not depend upon those sentences. They have content naturally, whether or not content happens to be ascribed to them.     

Pragmatism,bioethics and the grand American social experiment

There is tension in bioethics between two strains of pragmatism. The most prominent strain, following John Dewey, proposes a content-rich ethos of controlled, collective moral inquiry. A second strain, descending from Charles Peirce and Josiah Royce, favors an open-ended approach where diverging moral communities evolve without extensive inter-communal oversight. This essay defends the second strain. The Deweyan approach, I argue, exhibits a problematic quasi-foundationalist character insofar as it canonizes a dubious constellation of "liberal" political values and seeks to establish these values by interposing a consensus of moral experts where genuine inter-communal dialogue, and compromise, would be more fruitful. I hold that the alternative approach of Peirce and Royce is preferable, and truer to the fundamental commitments of classical American pragmatism. Recognizing the epistemic fallibility of various content-rich moral-political formulations, Peirce and Royce hope to cultivate and sustain moral inquiry by allowing each moral community (1) to generate and test its own moral system (as long as it does so peaceably) and (2) to freely make or refuse to make collaborative arrangements with other moral communities. This approach is illustrated in a brief discussion of the Oregon Medical Experiment.     

China's importation of Western psychiatry: Cultural relativity and mental disorders

As one aspect of China's modernization, the importation of Western psychiatric ideas poses a mystery. How are such ideas integrated with traditional assumptions? The apparently wholesale adoption of Western psychiatric categories runs counter to the fact that the Chinese have been generally reluctant to define problems in highly individualized psychiatric terms. Our lack of knowledge as to how the Chinese and Western medical models interface raises questions about the cross-cultural applicability of psychiatric theory. Ironically, the very conceptual categories intended to facilitate professional discourse obscure cultural, political, and epistemological differences between Chinese and Western thought. This paper focuses on certain incongruities in psychiatric theory and practice in order to underscore many unresolved issues that still exist with respect to our cross-cultural understandings of ‘mental illness’. Insofar as the trend has been towards standardizing methodology, taxonomies have been generated without a corresponding development in textured comparison. Originating from Western theoretical frameworks, comparative analyses have been otherwise devoid of culture-specific knowledge. The goal of this paper is to show that these categorical assumptions are still premature, and that examining the meaning of current ‘rates of mental illness’ in China specifically raises more questions than it answers. Hopefully, this discussion will stimulate a renewed interest in ethnographic methods that would uncover locally-based understandings and thereby create the basis for a more sophisticated epidemiological comparison.