Culture as an ingredient of personalized medicine

Matheson, Kimberly; Bombay, Amy; Anisman, Hymie

doi:10.1503/jpn.170234

Cited by 17 publications

(18 citation statements)

References 25 publications

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“…Alongside a call for personalized treatments for mental illnesses, consideration of cultural and social contexts in which individuals are embedded may be critical to the success of such approaches. Indeed, without such contextual considerations, treatment approaches risk contributing to the proliferation of stressors socially marginalized group members must contend with following traumatic events (Kirmayer and Craffa, 2014; Matheson et al, 2018).…”

Section: Resultsmentioning

confidence: 99%

Traumatic Experiences, Perceived Discrimination, and Psychological Distress Among Members of Various Socially Marginalized Groups

et al. 2019

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Perceived discrimination has consistently been shown to be associated with diminished mental health, but the psychological processes underlying this link are less well understood. The present series of four studies assessed the role of a history traumatic events in generating a proliferation of discrimination stressors and threat appraisals, which in turn predict psychological distress (depressive and posttraumatic stress symptoms) (mediation model), or whether prior traumatic events sensitize group members, such that when they encounter discrimination, the link to stress-related symptoms is heightened (moderation model). Each of the studies assessed a different marginalized group in Canada, including Indigenous peoples, Blacks, Jews, and a diverse sample of women. Participants completed measures assessing history of traumatic events, perceived explicit and ambiguous discrimination, discrimination threat appraisals, and symptoms of depression and posttraumatic stress. The four populations varied in their experiences, with Indigenous peoples encountering the highest levels of trauma, discrimination, and psychological distress symptoms. A mediated model was evident among Indigenous peoples and women, possibly reflecting the role of systemic processes that engender discrimination when traumatic events are experienced. There was evidence for a moderating role of a history of traumatic events on the relations between discrimination and depressive symptoms among Jewish and Black participants. Although the hypothesized synergistic effects of traumatic experiences were noted when assessing the relation between perceived discrimination and depressive symptoms among Jews, the presence of trauma blunted these relations among Blacks. The results suggest that trauma-informed approaches to addressing stress-related processes and psychological outcomes need to consider the unique social context of members of various socially marginalized groups.

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Section: Resultsmentioning

confidence: 99%

Traumatic Experiences, Perceived Discrimination, and Psychological Distress Among Members of Various Socially Marginalized Groups

et al. 2019

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“…A larger sample ideally might have allowed for assessment of gene x environment variations among other ethnic groups. This is particularly of interest when we consider the importance of culture in personalized medicine (68, 69). Moreover, there is a possibility that the different cytokine SNPs assessed independently might be additively or interactively linked to depressive symptoms.…”

Section: Discussionmentioning

confidence: 99%

Understanding the Relation Between Early-Life Adversity and Depression Symptoms: The Moderating Role of Sex and an Interleukin-1β Gene Variant

et al. 2019

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Pro-inflammatory cytokines, such as interleukin (IL)-6 and tumor necrosis factor-α (TNF-α), are thought to play a fundamental role in the pathogenesis of depression within a subset of individuals. However, the involvement of IL-1β has not been as consistently linked to depression, possibly owing to difficulties in detecting this cytokine in blood samples or that changes in circulating levels might only be apparent in a subgroup of patients who have experienced early-life adversity. From this perspective, the association between early-life adversity and depressive illness might depend on genetic variants regulating IL-1β activity. Considering the inflammatory-depression link, and that women are twice as likely to experience depression compared to men, the current study ( N = 475 university students) examined the moderating role of three independent cytokine single nucleotide polymorphisms (SNPs; IL-1β rs16944, IL-6 rs1800795 SNP, TNF-α rs1800629) in the relationship between early-life adversity and depressive symptoms, and whether these relations differed between males and females. The relation between childhood adversity and depressive symptoms was moderated by the IL-1β SNP, and further varied according to sex. Specifically, among females, higher childhood maltreatment was accompanied by elevated depressive symptoms irrespective of the IL-1β SNP, but among males, this relationship was particularly pronounced for those carrying the GG genotype of the IL-1β SNP. These findings suggest that, in the context of early life adversity, genetic variations of IL-1β functioning are related to depressive symptomatology and this may vary among males and females. The present study also, more broadly, highlights the importance of considering the confluence of experiential factors (e.g., early life adversity) and personal characteristics (e.g., sex and genetics) in understanding depressive disorders, an approach increasingly recognized in developing personalized treatment approaches to this illness.

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“…Cultural identity is rooted in systems of knowledge, collective trauma and evolving contexts (Matheson et al., 2018). Culture is both social and individual; an individual may turn to her/his roots as a source of resilience in processes, such as meaning making, storytelling, social support seeking and the mobilization of collective action, or alternatively, an individual may reject her/his indigenous identity due to shame, resentment or anxiety (Matheson et al., 2018). As exemplified in the stories told by our participants, indigenous peoples’ health is connected to the ongoing and lingering impacts of colonization (Allen et al., 2014; Gracey and King, 2009; King et al., 2009).…”

Section: Discussion: Communicating Mental Health In An Indigenous Contextmentioning

confidence: 99%

“We belong to nature”: Communicating mental health in an indigenous context

Sørly

Mathisen

Kvernmo

2020

Qualitative Social Work

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The approach to standardized services in Norwegian mental health care is tailored to the needs of the majority population, focusing on diagnoses and overshadows an approach that understands, values and emphasizes Sámi storytelling and everyday life. This study aims to contribute knowledge regarding the promotion of user involvement in mental health care from the perspectives of Sámi mental health care users. A narrative approach offers an opportunity to unravel an indigenous approach to mental health care and user involvement. People organize their storytelling according to culturally available narratives. This paper focuses on 9 Sámi men’s and women’s stories related to user involvement in mental health care services. Through a thematic analysis of personal stories, we emphasize how the participants make sense of their needs as patients in a culturally adapted mental health context and their experiences living in Sámi core areas. The following four themes are identified as prerequisites for user involvement in services: (1) the expectation of raising children to be independent, (2) the importance of accepting and recognizing the Sámi identity, (3) the need to live in close relations with nature and family, and 4) the right to be in the Sámi mode. Based on the results of our analysis, we find that user involvement among Sámi mental health care users is related to important Sámi values and norms within the culture and that treatment without these important values could adversely affect user involvement in mental health services.

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Culture as an ingredient of personalized medicine

Cited by 17 publications

References 25 publications

Traumatic Experiences, Perceived Discrimination, and Psychological Distress Among Members of Various Socially Marginalized Groups

Traumatic Experiences, Perceived Discrimination, and Psychological Distress Among Members of Various Socially Marginalized Groups

Understanding the Relation Between Early-Life Adversity and Depression Symptoms: The Moderating Role of Sex and an Interleukin-1β Gene Variant

“We belong to nature”: Communicating mental health in an indigenous context

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