Introduction to the Special Issue on Mental Health Self-Help

Since the 1950s, people with mental illness and their families have been organizing a wide range of self-directed, mutual support oriented initiatives, including self-help groups, nonprofit organizations, and businesses. These initiatives have become increasingly widespread over the years and today mental health self-help initiatives outnumber traditional mental health organizations in the United States (Goldstrom et al., Admin Policy Mental Health Mental Health Serv Res 33:92-103, 2006). Mental health self-help embodies much of what community psychologists promote, including the self-directed organization of people to create social change and facilitate personal transformation. This special issue provides new insight into several prominent areas of inquiry surrounding these low-cost interventions including: (1) their evidence base; (2) the processes by which people benefit; (3) how they interface with the mental health system; and (4) the value dilemmas they face.     

Money does not bring well‐being,but it does help! The relationship between financial resources and life satisfaction of the chronically ill mediated by social deprivation and loneliness

Chronically ill people have lower incomes and higher illness‐related costs than the general population. Therefore, their financial situation can be considered vulnerable, like their health. The aims of this study were (1) to assess the strength of the relationship between financial resources and life satisfaction of patients with chronic physical illness and (2) to investigate the mediating roles of social deprivation and loneliness in this relationship. Data were used of 1265 patients diagnosed with one or more somatic chronic disease(s), aged 25 years and older, who were recruited from 56 general practices in The Netherlands. GPs provided data on diagnoses and illness duration; chronically ill patients provided data on their functional status, financial situation, social deprivation, loneliness and life satisfaction. Data were analysed by means of correlation and linear regression analyses as well as LISREL path analysis. Available income correlates 0.13 with life satisfaction, which is similar to correlations found in general Western populations. The effect of available income on life satisfaction is mainly an indirect effect that can be explained by the mediating roles of social deprivation and loneliness. Policy should pay specific attention to income support of the chronically ill and disabled in order to improve their opportunities for social participation and increase the quality of their life. Copyright © 2007 John Wiley & Sons, Ltd.     

Perfectionism and Depression Among Low-Income Chronically Ill African American and White Adolescents and Their Maternal Parent

Most research on perfectionism is based on convenience samples of university students or clinically distressed samples, and therefore relatively less is known about the development and implications of perfectionism for other groups. In this study, we examined perfectionism and depression in low-income African American (n = 39) and White (n = 55) adolescents with chronic illnesses (most with diabetes, asthma, and/or hypertension) and their primary parents. We specifically examined the association between parent and child perfectionism, and the link between perfectionism and depression in both groups. The African American adolescents reported significantly more maladaptive perfectionism than did the White adolescents, and the African American parents reported significantly higher scores on depression than did the White parents. Correlations and regression analyses revealed similarities and differences in perfectionism-depression associations that might be explained in light of cultural differences and the unique physical and emotional challenges faced by youth with chronic illnesses. The word “parent” in this study is used to represent a parent or other adult who was identified as a primary caregiver for the adolescent.     

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.

From Masturbation to Homosexuality: A Case of Displaced Moral Disapproval

I argue that the decline in moral disapproval of masturbation in the American religious culture over the last half-century is directly responsible for increased moral disapproval of homosexuality. Moral disapproval previously directed toward masturbators is being redirected instead toward homosexuals. Since masturbation has been practiced by the overwhelming majority of individuals who self-identify with the American religious culture, while homosexual acts have been engaged in by a significantly smaller number of individuals who self-identify with this culture, the displacement of moral disapproval from masturbatory behavior to homosexual behavior leads to the stigmatization of those who engage in homosexual behavior, and an attitude of moral superiority and personal condescension inevitably follows. Nineteenth and twentieth century writings on the perils and evils of masturbation are cited in support of this argument.     

Changes in Attitudes Toward Religion Among Those with Mental Illness

Despite the increased attention given to the religious experiences of those with mental illness, the specific nature of the changes in religious attitudes that occur within this population remain yet unknown. In this study, 406 individuals with persistent mental illness who attended one of 13 Los Angeles County Mental Health facilities completed a demographic questionnaire, an adapted version of the Religious Coping Index, and the Symptom Checklist 90-R. Over 54% of the participants reported a change in their religious beliefs such that their faith became stronger or weaker as a result, and 66% perceived these changes to be positive in nature. Qualitative codings suggest that a constructive or destructive use of religion and the quality of one's self-image and relationship with God are the primary themes underlying these changes. Those changes that were predominantly positive were associated with less severe symptomatology and more religious coping when compared to predominantly negative changes. These findings suggest that religious attitudes may be an ongoing and dynamic part of the experience of mental illness that should be considered in the treatment and research afforded by mental health professionals.     

Adolescent Neurodevelopment and Psychopathology

Adolescence is a high-risk period for the onset of psychopathology. The occurrence of depression increases markedly in the years following the onset of puberty, and most individuals who are eventually diagnosed with a psychotic disorder show a marked rise in adjustment problems during adolescence. It is well established that puberty involves increases in the secretion of gonadal hormones. More recently, research has shown that stress hormones show a similar normative rise following puberty. Accumulating findings indicate that the postpubescent period is also characterized by significant neurodevelopment; there are changes in brain structure and function that are partially a consequence of hormonal factors. Researchers are now challenged to elucidate the neural mechanisms relating postpubertal neurodevelopment with the elevations in risk for psychopathology that characterize adolescence. One plausible mechanism is the effect of hormones on gene expression. The normal neuromaturational processes observed in adolescence partially reflect the effect of gonadal hormones on the expression of genes that control brain development. Hormone surges following puberty may also trigger the expression of genes that code for brain abnormalities that give rise to mental disorders.     

Secondary Beliefs: A Mediator between Illness Representations and Coping Behavior in Arthritis Sufferers

The aim of the current study was to investigate the factors of secondary beliefs and illness representations, and their relationship with particular coping strategies used in the management of arthritis, and more specifically, if secondary beliefs, as defined in Rational Emotive Behavioral Therapy (REBT), mediated the relationship between illness representations and coping, as outlined by the Self-Regulatory Model (SRM). A sample of 63 arthritis sufferers aged between 32.0 and 100.1 years was recruited. Participants were asked to complete three questionnaires: Ways of Coping Questionnaire (WOCQ); revised Illness Perception Questionnaire (IPQ-R); Secondary Beliefs Scale (SBS). Analyses revealed that all eight coping strategies measured were significantly related to one or more illness representation, lending support to the SRM. Furthermore, secondary beliefs were found to mediate the relationship between illness representations and coping for three of the strategies measured: confrontive coping, accepting responsibility and seeking social support, while they also appeared to be directly related to the escape-avoidance strategy. Therefore, support for the REBT model was also evidenced. Overall, these results have highlighted the importance of cognitive factors in influencing coping behavior, a finding that could prove useful when designing interventions aiming to promote beneficial coping in arthritis sufferers.     

国外心理疾病烙印影响研究概述

心理疾病污名足加诸在心理疾病患者身上的耻辱标记,世界卫生组织2001年指出"心理和行为障碍患者康复的最大阻碍就是社会对他们的污名和与之相连的歧视".作者对国外污名领域的研究进行了回顾,论述了心理疾病污名的概念、有关其影响机制的理论和实证研究.从公众污名和自我污名两方面论述了污名对心理疾病患者的影响以及消除污名的方法.