The Practices of Apostolic Faith Healers in Mental Health Care in Zimbabwe

This study aimed to understand and interpret faith healers' explanations of the aetiology and treatment of diseases and to canvass their views regarding collaboration between Western trained health care professionals and faith healers. Fifteen female and six male faith healers from Apostolic churches in Marondera (Zimbabwe) were selected and interviewed (mean age = 42.38 years; age range = 20–69 years). All the faith healers interviewed had been practising from two to fifty years. Content analysis of the data indicated that faith healers use a variety of procedures like prayer, holy water, counselling and sacred stones during their healing sessions. Common ailments brought to the faith healers included mental disorders, infertility, substance abuse, sleep disorders, childhood problems and physical problems. Witchcraft and avenging spirits were cited as the most common causes for illness. Closer cooperation between Western trained health practitioners and traditional (faith) healers is needed in the treatment of both physical and mental illnesses.     

Self-complexity as a cognitive buffer against stress-related illness and depression

This prospective study tested the self-complexity buffering hypothesis that greater self-complexity moderates the adverse impact of stress on depression and illness. This hypothesis follows from a model that assumes self-knowledge is represented in terms of multiple self-aspects. As defined in this model, greater self-complexity involves representing the self in terms of a greater number of cognitive self-aspects and maintaining greater distinctions among self-aspects. Subjects completed measures of stressful events, self-complexity, depression, and illness in two sessions separated by 2 weeks. A multiple regression analysis used depression and illness at Time 2 as outcomes, stressful life events and self-complexity at Time 1 as predictors, and depression and illness at Time 1 as control variables. The Stress X Self-Complexity interaction provided strong support for the buffering hypothesis. Subjects higher in self-complexity were less prone to depression, perceived stress, physical symptoms, and occurrence of the flu and other illnesses following high levels of stressful events. These results suggest that vulnerability to stress-related depression and illness is due, in part, to differences in cognitive representations of the self.     

Children's conceptions of mental illness: A naïve theory approach

This paper reports two studies that investigated children's conceptions of mental illness using a naïve theory approach, drawing upon a conceptual framework for analysing illness representations which distinguishes between the identity, causes, consequences, curability, and timeline of an illness. The studies utilized semi‐structured interviewing and card selection tasks to assess 6‐ to 11‐year‐old children's conceptions of the causes and consequences (Study 1) and the curability and timeline (Study 2) of different mental and physical illnesses/ailments. The studies revealed that, at all ages, the children held coherent causal–explanatory ideas about the causes, consequences, curability, and timeline of both mental and physical illnesses/ailments. However, while younger children tended to rely on their knowledge of common physical illnesses when thinking about mental illnesses, providing contagion and contamination explanations of cause, older children demonstrated differences in their thinking about mental and physical illnesses. No substantial gender differences were found in the children's thinking. It is argued that children hold coherent conceptions of mental illness at all ages, but that mental illness only emerges as an ontologically distinct conceptual domain by the end of middle childhood.     

Knowledge and attitude of Malaysia’s Muslim faith healers in dealing with the mentally ill

Muslim faith healers are often sought by the Malaysian public as an avenue to address psychological distress. “Ruqyah” refers to the recitation of verses from the Qur'an and/or sayings of Prophet Muhammad (PBUH) and is used by Muslim faith healers as a method of treatment. This study was conducted to assess the knowledge and attitude of Muslim faith healers in dealing with psychiatric patients in Malaysia. Seven Muslim faith healers were interviewed. The interviews were transcribed verbatim, and analysed qualitatively using thematic content analysis. The authors identified four themes: understanding of psychiatric illnesses, diagnostic competence, patients' referral, and integrating “ruqyah” into mainstream psychiatry. It was found that the respondents had limited knowledge of psychiatric illness, focusing on “ruqyah” as the main intervention in treating psychiatric illness. Recognizing the important role played by Muslim faith healers in the treatment of psychiatric illness in Malaysia, collaboration between them and fellow psychiatrists is deemed highly necessary.     

Diagnosing depression in patients with physical diseases using the beck depression inventory (BDI)

Abstract

Four-hundred-and-forty-three patients with a physical illness (355 with coronary heart disease and 88 with chronic pain), 150 unemployed persons and 623 subjects from the normal population in Jämtland, Sweden were tested using the BDI (Beck Depression Inventory). The aim of the study was to investigate whether scores on both the physical and non-physical components of the BDI differed between the patients and the other groups, or whether only the physical component was significantly higher in the patient group, and in such a case whether this could be interpreted as symptomatic of physical disease and not of depression. A cutoff score of ≥ 10 to determine mild depression and two different alternative physical and non-physical components were used. Forty-three percent of the patients with coronary heart disease and 50% of patients with chronic pain were categorized as being at least mildly depressed. Factor analyses indicated that a physical component comprising five items was the most meaningful and could best discriminate the physical symptoms. The patients' scores were significantly higher than those of the other two groups on the physical component but only higher than the normal population sample on the nun-physical component. This supports the idea that the items for physical symptoms in the BDI might be confounding when determining depression in patients with physical diseases. The non-physical component seems to be the best indicator of depression and is recommended as a complement to the total BDI scale when determining the degree of depression in patients suffering from a physical disease.     

Protective functions of health and self-esteem against depression in older adults facing illness or bereavement

Four functions were examined by which health and self-esteem could ward off depression over time in older adults. Adults (N = 1,074)--55 years and older--were interviewed 5 times at 6-month intervals. Demographic and prevent depression controls were included. Neither health nor self-esteem served as an interactive buffer. Both had direct negative effects on depression, independent of events, over 2 years. Neither illnesses nor bereavements had direct effects on depression; both had indirect effects through other events; illness also had indirect effects by weakening health. Health had stronger preventive effect on illnesses but was more vulnerable to undesirable events than was self-esteem. There was little support for the specificity hypothesis that a close match between event and resource would increase resource effects.     

Longitudinal relationships between depressive symptoms and health in normal older and middle-aged adults

Comorbidity between health and depression is salient in late life, when risk for physical illness rises. Other community studies have not distinguished between the effects of brief and long-standing depressive symptoms on excess morbidity and mortality. S. Cohen and M. S. Rodriguez's (1995) differential hypothesis of pathways between depression and health was used to examine the relationships between health and depression in a prospective probability sample of 1,479 community-resident middle-aged and older adults. Findings suggest that different durations of depressive symptoms have different relationships to health. Health had an impact on short-term increases in depressive symptoms but depressive symptoms had a weaker impact on health. The reciprocal impact was indistinguishable from the health influence on depression. In contrast, longer term depressive symptoms had a clear impact on health. The results imply that physical illness can affect depressive states; depressive traits but not states can affect illness.     

A Systematic Review of the Literature Exploring Illness Perceptions in Mental Health Utilising the Self-Regulation Model

Psychologists have utilised a range of social cognition models to understand variation in physical health and illness-related behaviours. The most widely studied model of illness perceptions has been the Self-Regulation Model (SRM, Leventhal, Nerenz, & Steele, 1984). The illness perceptions questionnaire (IPQ) and its revised version (IPQ-R) have been utilised to explore illness beliefs in physical health. This review examined 13 quantitative studies, which used the IPQ and IPQ-R in mental health in their exploration of illness perceptions in psychosis, bipolar disorder, eating disorders, depression and adolescents experiencing mood disorders. Across these studies the SRM illness dimensions were largely supported. Mental illnesses were commonly viewed as cyclical and chronic, with serious negative consequences. Perceptions regarding chronicity, controllability and negative consequences were associated with coping and help seeking, while engagement with services and help seeking were also related to illness coherence beliefs. Treatment adherence was linked to beliefs that treatment could control one’s illness. Whilst a major limitation of the reviewed studies was the use of cross-sectional designs, overall the applicability of the SRM to mental health was supported. The IPQ and IPQ-R were shown to be valuable measures of illness perceptions in mental health, offering implications for clinical practice.     

Children's recognition of time in the causes and cures of physical and emotional reactions to illnesses and injuries

The present set of studies examined children's and college students' recognition of the role of time in the manifestation of causes and cures for illnesses and injuries. In Study 1, participants ranging from 4‐year‐olds through college students were presented with biological, moral, psychological, and irrelevant causes for illness symptoms and were asked how much time elapsed between the cause and the symptom. They were also asked if medicine would make the person feel better and if so how much time elapsed between taking the medicine and feeling better. Study 2 replicated Study 1 with 4‐ and 5‐year‐olds. Study 3 examined whether 4‐ and 5‐year‐olds and college students could differentiate between physical and emotional reactions to illnesses and injuries, with regard to time course. Overall, young children underestimate how long it takes for illness symptoms to emerge (expecting them to result right away following exposure to contamination). Nonetheless, children generated longer timelines for biological cures than biological causes. Moreover, 4‐ and 5‐year‐olds expect physical and emotional reactions to follow different time courses. These results suggest that young children have a nascent expectation that biological events are distinct from non‐biological events, in how they unfold over time.     

Conceptualising mental health in the United Arab Emirates: the perspective of traditional healers

Substantial investments in health-care have ensured the widespread availability of allopathic medical services across the United Arab Emirates (UAE). However, in spite of this accessibility traditional healers (Mutawa) continue to play a significant, albeit, unofficial role in the UAE's health sector. Citizens routinely consult traditional healers for problems that might, from a western biomedical perspective, be considered psychiatric conditions. This qualitative study explores traditional healers' conceptualisations of mental health problems, discussing their perspectives on phenomenology, aetiology, intervention and outcome. Notably, traditional healers distinguished between biomedical illness and states they attributed to demonological or metaphysical causes. The Islamic spiritual narrative was central to discussions of aetiology, intervention and outcome. Greater integration of traditional healers within the UAE's mental health-care services would, in many cases, improve patient experience and outcomes.     

A View of the violence contained in chronic fatigue syndrome

In this paper I ask whether there might be any one particular psychopathology likely to be linked specifically with the physical illness known as chronic fatigue syndrome (CFS) or myalgic encephalomyelitis (ME), and whether CFS/ME aids and abets and 'fits' an original mental state. I think the question cannot yet be answered. However it is my hypothesis that in some personality structures the onset of CFS/ME following a physical illness exacerbates negativity and is an aspect of ordinary depression where there is a lowering of energy levels and a loss of zest for life, or it may reveal the pathological aspect of unresolved rage.
Depending on the degree of pathological disturbance, working with and through the rage may or may not result in a resolution of the symptoms of ME. In this paper I consider some of the problems in the transference and countertransference relationship, which make it extremely difficult to separate out reality from phantasy. There is then the further problem of the denial of the psyche by the patient as part of the violence inherent in the illness.
One case is presented, an example of ME in a borderline male patient in whom resolution could not be achieved.     

South African Muslim Faith Healers Perceptions of Mental Illness: Understanding,Aetiology and Treatment

The important role that religious beliefs may have on perceptions of mental illness cannot be ignored. Many religions including Islam advocate witchcraft and spirit possession—all of which are thought to influence the behaviour of a person so as to resemble that of a mentally ill individual. Thus this research explored Muslim Faith Healers perceptions of mental and spiritual illness in terms of their understanding of the distinctions between the two, the aetiologies and the treatments thereof. Six Muslim Healers in the Johannesburg community were interviewed and thematic content analysis was used to analyse the data. From the results it is clear that the faith healers were aware of the distinction between mental and spiritual illnesses. It was also apparent that Islam has a clear taxonomy that distinguishes illness and the causes thereof. Treatments are then advised accordingly. Thus this paper argues that the predominant Western view of the aetiology and understanding of mental illness needs to acknowledge the various culturally inclined taxonomies of mental illness so as to better understand and aid clients.

Narcissism and depression: MMPI-2 evidence for the continuum hypothesis in clinical samples

According to one hypothesis, self-report measures of narcissism help describe a psychological continuum related to self-esteem. Most of the previous support for this idea appeared in studies of undergraduates responding to the Narcissistic Personality Inventory (NPI; Raskin & Hall, 1981) along with other self-report instruments. In this project, results consistent with the continuum hypothesis were obtained when Minnesota Multiphasic Personality Inventory-2 (MMPI-2; Butcher, Dahlstrom, Graham, Tellegen, & Kaemmer, 1989) narcissism scales were correlated with depression in adults receiving treatment for alcoholism. Essentially identical outcomes emerged in a second sample of state psychiatric hospital patients. A third study upheld the hypothesis when narcissism scales were correlated with clinical assessments rather than self-reports of depression. None of these findings were easily explained in terms of alternative interpretations of self-reported narcissism, and these data demonstrate that empirical support for the continuum hypothesis was not limited to the NPI, undergraduates, or self-report measures.     

A Comparison of Mood and Quality of Life Among People with Progressive Neurological Illnesses and Their Caregivers

The current study was designed to investigate differences in mood and a range of QOL domains among 423 patients and 335 caregivers of people with motor neurone disease (MND), Huntington’s disease (HD), Parkinson’s, and multiple sclerosis (MS). Patients and caregivers completed an anonymous questionnaire that evaluated their mood (anxiety, depression, fatigue, confusion) and QOL (physical, psychological, social, environment). The results demonstrated that caregivers of people with MND and HD experienced most problems with their mood and QOL compared to caregivers of people in the other illness groups. There were few differences in mood or QOL between patients and caregivers. Patients generally showed greater confusion, physical impairment, and psychological maladjustment. The findings suggest that educational and intervention programs need to be developed to help both patients and their caregivers to adjust and cope with these illnesses, particularly caregivers of people with MND and HD.     

Depression, Psychological Resources, and Health-Related Quality of Life in Older Adults 75 and Above

The purposes of this study were (1) to compare psychological resources and health-related quality of life between two groups of community-dwelling elders, 75 years of age and older, with similar chronic illnesses, but with varying levels of depression, and (2) to examine the relationships among depression, psychological resources, and health-related quality of life. Fifty-two elders (14 men and 38 women) were divided into mildly (n = 18) and severely (n = 34) depressed groups based on their depression scores. There were no significant differences between the two groups for demographic and illness characteristics. There were significant differences for number of medications, mastery, health perceptions, mental health functioning, and well-being. Severely depressed elders had poorer health perceptions, and decreased mastery, functioning, and well-being as compared with mildly depressed elders. An explanatory model was developed using factor analysis that fit the data well. Health perceptions and mastery had direct influences on depression, and depression directly impacted well-being.     

Children's understanding of physical illnesses and psychological states

Abstract

The present study set out to compare 5.7, and 9-year-old children's understanding of a physical illness (chicken pox) with their understanding of a psychological state (depression). In addition, information about personal experience of the illnesses and external sources of information was elicited, in order to assess the effects of both age and experience. Children at all ages showed a basic intact knowledge of both chicken pox and depression, although older children had a more sophisticated understanding of depression, and had acquired this knowledge from a greater number of sources. The clinical implications of the findings, and their relationship to both neo-Piagetian and more recent theories of conceptual development in childhood are discussed.     

Illness intrusiveness and quality of life in end-stage renal disease: comparison and stability across treatment modalities

Investigated the degree to which chronic, life-threatening illness and its treatment interfere with continued involvements in valued activities and interests--that is, illness intrusiveness--and its impact on quality of life in end-stage renal disease. Data were collected on two occasions separated by a lag of 6 weeks. Mixed analyses of variance indicated that life domains were affected differentially across treatments. Perceived illness intrusiveness correlated significantly with treatment time requirements, uremic symptoms, intercurrent nonrenal illnesses, fatigue, and difficulties in daily activities. Significant quality-of-life differences were observed across treatment modalities for satisfaction/happiness and pessimism/illness-related concerns but not for depression/distress. Perceived illness intrusiveness correlated significantly with each of these quality-of-life measures. Results were stable over time. These findings substantiate the construct of illness intrusiveness as a mediator of the psychosocial impact of chronic, life-threatening illness.     

A qualitative study of primary health care access, barriers and satisfaction among people with mental illness

Research has found that a substantial proportion of individuals with mental illness have high morbidity and mortality rates, and high under-diagnosis of major physical illnesses. Furthermore, people with a mental illness tend not to seek out or utilise health care services. The reasons for the negative attitudes and behaviour towards health care services among this population have not been investigated. This paper presents findings from a study that investigated the health care service needs of people with mental illness (n = 20), and views from health care providers (n = 16) regarding access to these services by people with a mental illness. Results indicated that psychiatric patients identified a range of barriers to their health care usage and low levels of health care satisfaction. These views were shared with health care professionals. Reasons for these findings and strategies to address these problems so that there is better access to health care services for people with mental illness are discussed.