Inter-Relationships of Beliefs About Mental Illness, Psychiatric Diagnoses and Mental Health Care Delivery Among Africans

Ilechukwu, S.T.C.

doi:10.1177/002076408803400305

Cited by 20 publications

(13 citation statements)

References 10 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…In the few studies involving participants clinically diagnosed with depression, “thinking too much” was frequently used to describe their illness (Abdul Kadir & Bifulco, 2010; Okello et al, 2012; Parker et al, 2001; Patel & Mann, 1997), was named as a primary cause (Ilechukwu, 1988), or was endorsed significantly more by depressed than non-depressed individuals (Rasmussen et al, 2015). Of the studies that named one or more comparative psychiatric diagnoses, approximately one-fifth provided no further explanation or justification for the comparison.…”

Section: Resultsmentioning

confidence: 99%

“Thinking too much”: A systematic review of a common idiom of distress

Kaiser¹,

Haroz²,

Kohrt³

et al. 2015

Social Science & Medicine

225

175

View full text Add to dashboard Cite

Idioms of distress communicate suffering via reference to shared ethnopsychologies, and better understanding of idioms of distress can contribute to effective clinical and public health communication. This systematic review is a qualitative synthesis of “thinking too much” idioms globally, to determine their applicability and variability across cultures. We searched eight databases and retained publications if they included empirical quantitative, qualitative, or mixed-methods research regarding a “thinking too much” idiom and were in English. In total, 138 publications from 1979–2014 met inclusion criteria. We examined the descriptive epidemiology, phenomenology, etiology, and course of “thinking too much” idioms and compared them to psychiatric constructs. “Thinking too much” idioms typically reference ruminative, intrusive, and anxious thoughts and result in a range of perceived complications, physical and mental illnesses, or even death. These idioms appear to have variable overlap with common psychiatric constructs, including depression, anxiety, and PTSD. However, “thinking too much” idioms reflect aspects of experience, distress, and social positioning not captured by psychiatric diagnoses and often show wide within-cultural variation, in addition to between-cultural differences. Taken together, these findings suggest that “thinking too much” should not be interpreted as a gloss for psychiatric disorder nor assumed to be a unitary symptom or syndrome within a culture. We suggest five key ways in which engagement with “thinking too much” idioms can improve global mental health research and interventions: it (1) incorporates a key idiom of distress into measurement and screening to improve validity of efforts at identifying those in need of services and tracking treatment outcomes; (2) facilitates exploration of ethnopsychology in order to bolster cultural appropriateness of interventions; (3) strengthens public health communication to encourage engagement in treatment; (4) reduces stigma by enhancing understanding, promoting treatment-seeking, and avoiding unintentionally contributing to stigmatization; and (5) identifies a key locally salient treatment target.

show abstract

Section: Resultsmentioning

confidence: 99%

“Thinking too much”: A systematic review of a common idiom of distress

Kaiser¹,

Haroz²,

Kohrt³

et al. 2015

Social Science & Medicine

225

175

View full text Add to dashboard Cite

show abstract

“…Causal beliefs are usually classified along three dimensions: biological (schizophrenia is a brain disorder due in part to hereditary factors), psychosocial (schizophrenia is caused by external factors such as economic conditions, stressors or level of educational attainment) and magical-religious (schizophrenia originates from supernatural or spiritual forces). In patients with schizophrenia and their caregivers, studies reported a preference for attributing schizophrenia to psychosocial causes in diverse cultures, such as the United Kingdom (Pollock, 1988), Turkey (Karanci, 1995), China (Phillips et al, 2000) Germany (Holzinger et al, 2003) and Nigeria (Ilechukwu, 1988). Supernatural causes were common beliefs in patients with schizophrenia in India (Saravanan et al, 2007; Kate et al, 2012) and Israel (Al-Krenawi, 1999).…”

Section: Introductionmentioning

confidence: 99%

The relationships between patients’ and caregivers’ beliefs about the causes of schizophrenia and clinical outcomes in Latin American countries

Caqueo-Urízar

Boyer

Baumstarck

et al. 2015

Psychiatry Research

View full text Add to dashboard Cite

Beliefs about the causes of schizophrenia are thought to impact treatment outcomes. We investigated 3 theoretically opposing belief systems (biological, psychosocial, magical-religious) in relation to the severity of positive and negative symptoms and to attitudes towards medications. We recruited 253 patients with schizophrenia and their primary caregivers from public mental health clinics in Bolivia, Chile, and Peru. We assessed patients’ and caregivers’ beliefs about the causes of schizophrenia, which were used as predictors of symptom severity and medication attitudes in linear regression analyses. Patients’ scores on biological, psychosocial, and magical-religious beliefs were positively correlated with one another, indicating that these domains were not, as anticipated, “opposing.” Patients with higher levels of biological and psychosocial beliefs had significantly lower levels of positive and negative symptoms; in contrast, higher levels of magical-religious beliefs were associated with increased positive symptoms and less favorable attitudes towards medications. Patients’ belief systems are significant predictors of symptom severity and medication attitudes. Research is needed on the extent to which psychotherapeutic treatments for schizophrenia should bolster patients’ beliefs in the biological and psychosocial domains and weaken beliefs in the magical-religious domain; this research should also attend to the ethical considerations involved in intervening on belief systems cross-culturally.

show abstract

“…[1,5,10-12]]. In a study of Nigerian psychiatric out-patients approximately half of the participants attributed their illness to supernatural causes [10]. All of the 60 patients in Al-Krenawi's study of Bedouin-Arab psychiatric outpatients in Israel attributed their disorder to supernatural causes [1].…”

Section: Introductionmentioning

confidence: 99%

“…In the Nigerian sample referred to above [10] women and the more educated more commonly attributed their illness to psychosocial causes rather than to supernatural causes. However, in Al-Krenawi's study [1] causal beliefs were not related to gender, education, social class or type of illness.…”

Section: Introductionmentioning

confidence: 99%

Illness causal beliefs in Turkish immigrants

2007

View full text Add to dashboard Cite

BackgroundPeople hold a wide variety of beliefs concerning the causes of illness. Such beliefs vary across cultures and, among immigrants, may be influenced by many factors, including level of acculturation, gender, level of education, and experience of illness and treatment. This study examines illness causal beliefs in Turkish-immigrants in Australia.MethodsCausal beliefs about somatic and mental illness were examined in a sample of 444 members of the Turkish population of Melbourne. The socio-demographic characteristics of the sample were broadly similar to those of the Melbourne Turkish community. Five issues were examined: the structure of causal beliefs; the relative frequency of natural, supernatural and metaphysical beliefs; ascription of somatic, mental, or both somatic and mental conditions to the various causes; the correlations of belief types with socio-demographic, modernizing and acculturation variables; and the relationship between causal beliefs and current illness.ResultsPrincipal components analysis revealed two broad factors, accounting for 58 percent of the variation in scores on illness belief scales, distinctly interpretable as natural and supernatural beliefs. Second, beliefs in natural causes were more frequent than beliefs in supernatural causes. Third, some causal beliefs were commonly linked to both somatic and mental conditions while others were regarded as more specific to either somatic or mental disorders. Last, there was a range of correlations between endorsement of belief types and factors defining heterogeneity within the community, including with demographic factors, indicators of modernizing and acculturative processes, and the current presence of illness.ConclusionResults supported the classification of causal beliefs proposed by Murdock, Wilson & Frederick, with a division into natural and supernatural causes. While belief in natural causes is more common, belief in supernatural causes persists despite modernizing and acculturative influences. Different types of causal beliefs are held in relation to somatic or mental illness, and a variety of apparently logically incompatible beliefs may be concurrently held. Illness causal beliefs are dynamic and are related to demographic, modernizing, and acculturative factors, and to the current presence of illness. Any assumption of uniformity of illness causal beliefs within a community, even one that is relatively culturally homogeneous, is likely to be misleading. A better understanding of the diversity, and determinants, of illness causal beliefs can be of value in improving our understanding of illness experience, the clinical process, and in developing more effective health services and population health strategies.

show abstract

Inter-Relationships of Beliefs About Mental Illness, Psychiatric Diagnoses and Mental Health Care Delivery Among Africans

Cited by 20 publications

References 10 publications

“Thinking too much”: A systematic review of a common idiom of distress

“Thinking too much”: A systematic review of a common idiom of distress

The relationships between patients’ and caregivers’ beliefs about the causes of schizophrenia and clinical outcomes in Latin American countries

Illness causal beliefs in Turkish immigrants

Contact Info

Product

Resources

About