The Effects of Adult Aging and Culture on Theory of Mind.

OBJECTIVES: Older adults tend to have poorer Theory of Mind (ToM) than their younger counterparts, and this has been shown in both Western and Asian cultures. We examined the role of working memory (WM) in age differences in ToM, and whether this was moderated by education and culture (the United Kingdom vs. Malaysia). METHODS: We used 2 ToM tests with differing demands on updating multiple mental states (false belief) and applying social rules to mental state processing (faux pas). We also looked at the role of education, socioeconomic status, and WM. A total of 298 participants from the United Kingdom and Malaysia completed faux pas, false belief, and WM tasks. RESULTS: Age effects on some aspects of ToM were greater in the Malaysian compared to the UK sample. Malaysian older adults were poorer at faux pas detection, aspects of false belief, and WM compared to young adults. In subsequent moderated mediation analyses, we found that, specifically in the Malaysian sample, the mediating effects of WM on the age and ToM relationship occurred at the lowest levels of education. DISCUSSION: This pattern of results may reflect changes in the familiarity and cognitive load of explicit mental state attribution, along with cultural differences in the pace and nature of cognitive aging. Cultural differences in education and WM should be considered when researching age differences in ToM.

Advancing Indigenous Mental Health Research: Ethical, conceptual and methodological challenges.

The articles in this issue of Transcultural Psychiatry point the way toward meaningful advances in mental health research pertaining to Indigenous peoples, illuminating the distinctive problems and predicaments that confront these communities as well as unrecognized or neglected sources of well-being and resilience. As we observe in this introductory essay, future research will benefit from ethical awareness, conceptual clarity, and methodological refinement. Such efforts will enable additional insight into that which is common to Indigenous mental health across settler societies, and that which is specific to local histories, cultures and contexts. Research of this kind can contribute to nuanced understandings of developmental pathways, intergenerational effects, and community resilience, and inform policy and practice to better meet the needs of Indigenous individuals, communities and populations.

Conviver com a incerteza relacionada com a doença neurodegenerativa hereditária: um estudo etnográfico / Living with uncertainty related to hereditary neurodegenerative disease: an ethnographical study

Introduction and Objectives: Familial Amyloidotic Polyneuropathy is an autosomal dominant disease and threatens the life of the gene carrier by extracellular deposition of transtirretin in the peripheral nervous system. This paper aims to describe how people living with Familial Amyloidotic Polyneuropathy experience the transition and uncertainty arising from the knowledge of the outcome of the pre-symptomatic genetic test. Methodology: focused ethnography study conducted in the community of Vila do Conde and Póvoa de Varzim. Data collection was performed through ethnographic interview to 31 patients. The collected data were verbatim transcribed and analyzed according to the qualitative data analysis procedures. Results and Discussion: Data have been narrowed into four categories that illustrate how people with Familial Amyloidotic Polyneuropathy, on the one hand, feel and live the uncertainty of the disease, and on the other hand explain the resources and conditions they must have to deal with this uncertainty. Thus, we have as categories, perform the presymptomatic test, personal conditions for transition, community conditions for transition and conditions of society for transition. The management of disease uncertainty is mediated by previous knowledge about a certain health condition, because it affects several generations of the same family, previous knowledge about the risk condition contributes to the acceptance of health status. Conclusions: It is important that nurses promote strategies that increase social and family support and assume as credible authorities in caring for people living with Andrade's disease, becoming facilitators of their personal growth and uncertainty management

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Influence of Spiritual Dimensions on Suicide Risk: The Role of Regional Differences.

The field of suicide prevention has been enriched by research on the association between spirituality and suicide. Many authors have suggested focusing on the various dimensions of religiosity in order to better understand the association between religion and suicidal risk, but it is unclear whether the relationship between spirituality and suicidality differs between countries with different cultures, life values, and sociohistorical experiences. To explore this, the aim of this multicenter study was to investigate the possible relationship between suicide and spirituality in Italy and Austria. In the two countries, two different groups of subjects participated: psychiatric patients and university students. The patients were evaluated with the Mini International Neuropsychiatric Interview. In addition, the following measures were used: a sociodemographic questionnaire, the Columbia-Suicide Severity Rating Scale-B, the Symptom-Checklist-90-Standard, and the Multidimensional Inventory for Religious/Spiritual Well-Being. Our results confirmed the multifactorial nature of the relation between suicide risk and the various religious/spiritual dimensions, including religious/spiritual well-being and hope immanent. However, regional differences moderated this relationship in both the clinical and nonclinical samples.

Cultural Differences in Reactions to Suicidal Ideation: A Mixed Methods Comparison of Korea and Australia.

There is evidence for cultural differences in mental health symptoms and help-seeking, but no past research has explored cultural differences in how people react to suicidal ideation communicated by others. Layperson reactions are critical, because the majority of people who experience suicidal ideation disclose to friends or family. Participants were 506 people aged 17-65 recruited from Australia and Korea who completed an experiment in which they responded to a friend who was experiencing either subclinical distress or suicidal ideation. Korean participants did not differentiate between the subclinical and suicidal targets, whereas Australian participants showed more concern for the suicidal target. For both targets, Korean participants were more likely to recommend passive coping strategies ("Time will solve everything" or "Cheer up"), while Australian participants were more likely to recommend active coping strategies ("Let's talk" or "See a doctor"). This study provides the first evidence of cultural differences in the way people typically respond to disclosures of suicidal ideation, and suggests that unhelpful and inappropriate recommendations are commonplace.

Feelings in the body: Cultural variations in the somatic concomitants of affective experience.

Affective science research has investigated how the sociocultural context shapes the bodily experience of emotion. Similarly, in the culture and mental health literature, there is a history of research on cultural variations in the presentation of somatic symptoms. A well-known example of the latter is the finding that Chinese depressed patients report more somatic symptoms compared to their "Western" counterparts. The present study represents a first step toward integrating these efforts. We examined reports of somatic and affective changes in 48 Chinese/Chinese American (CH) and 53 European American (EA) women responding to a sad film. Although CH and EA women reported experiencing similar levels of sadness, CH women experienced higher levels of somatic sensations (e.g., changes in heartbeat) relative to EA women. CH participants' reports of somatic changes were negatively associated with orientation to American culture. These findings suggest that cultural context shapes the subjective experience of somatic changes associated with sadness. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Mate wareware: Understanding 'dementia' from a Maori perspective.

AIM: To investigate Maori (Indigenous people of Aotearoa New Zealand) understandings of dementia, its causes, and ways to manage a whanau (extended family) member with dementia. METHOD: We undertook kaupapa Maori research (Maori informed research) with 223 kaumatua (Maori elders) who participated in 17 focus groups across seven study regions throughout Aotearoa New Zealand and eight whanau from the Waikato region. We audio recorded all interviews, transcribed them and then coded and categorised the data into themes. RESULTS: Mate wareware (becoming forgetful and unwell) ('dementia') affects the wairua (spiritual dimension) of Maori. The findings elucidate Maori understandings of the causes of mate wareware, and the role of aroha (love, compassion) and manaakitanga (hospitality, kindness, generosity, support, caring) involved in caregiving for whanau living with mate wareware. Participants perceived cultural activities acted as protective factors that optimised a person's functioning within their whanau and community. CONCLUSION: Whanau are crucial for the care of a kaumatua with mate wareware, along with promoting healthy wairua for all. Whanau urgently need information to assist with their knowledge building and empowerment to meet the needs of a member affected by mate wareware. This requires collaborative healthcare practice and practitioners accessing the necessary matauranga Maori (Maori knowledge) to provide culturally appropriate and comprehensive care for whanau.

Progress in psycho-oncology with special reference to developing countries.

PURPOSE OF REVIEW: Psycho-oncology has completed 25 years. There is growing recognition of the psychosocial needs of persons living with cancer and the role of sociocultural factors in addressing the needs. This review addresses the research in developing countries relating to distress associated with living with cancer and psychosocial care. RECENT FINDINGS: There is growing recognition of the emotional needs, understanding of the sociocultural aspects of the emotional responses of persons, caregivers, role of resilience and posttraumatic growth and spirituality in cancer care. Psychosocial aspects of cancer are largely influenced by social, economic, cultural, religious and health systems. A number of innovative approaches to care like use of yoga, financial and material support and involvement of caregivers have been implemented. A positive development is the increasing professional attention to document and develop innovative care programmes. SUMMARY: A significant proportion of the general population are living with cancer. There are significant psychosocial needs largely influenced by social, economic, cultural, religious aspects of the communities. There are a wide range of interventions from self-care to professional care to address the needs. In developing countries, there is need for longitudinal studies of psycho-social experiences, develop interventions that are culturally appropriate, along with enhanced use of information technology along with evaluation of interventions.

Culturally sensitive assessment of anxious-depressive distress in the Cambodian population: Avoiding category truncation.

In a large national survey in Cambodia (N = 2689), the present study investigated the prominence of certain culturally salient symptoms and syndromes in the general population and among those with anxious-depressive distress (as determined by the Hopkins Symptom Checklist-25, or HSCL). Using an abbreviated Cambodian Symptom and Syndrome Addendum (CSSA), we found that the CSSA complaints were particularly elevated among those with anxious-depressive distress. Those with anxious-depressive distress had statistically greater mean scores on all the CSSA items as well as severity of endorsement analyzed by percentage: among those with HSCL caseness, 75.3% were bothered "quite a bit" or "extremely" by "thinking a lot" (vs. 27.5% without caseness); 53.8% were bothered by "standing up and feeling dizzy" (vs. 13.8%); and 45.6% by blurry vision (vs. 16.8%). In a logistic regression analysis to predict anxious-depressive distress, 51% of the variance was accounted for by five predictors: "weak heart," "thinking a lot," dizziness, "khyâl hitting up from the stomach," and sleep paralysis. Using ROC analysis, a cut-off score of 1.81 on the CSSA was optimal as a screener to indicate anxious-depressive distress, giving a sensitivity of 0.86. The study results suggest that to avoid category truncation (i.e., the omission of key complaints that are part of an assessed distress domain) when profiling anxious-depressive distress among Cambodia population that items other than those in standard psychopathology measures should be assessed such as "thinking a lot," "weak heart," "blurry vision," and "dizziness upon standing up."

La psicología como técnica de subjetivación / Psychology as a technique of subjectification

Se propone de forma tentativa una concepción de la Psicología que pretende desplazar las cuestiones epistemológicas (qué clase de ciencia es, de serlo) y las teóricas y metodológicas (cuál debe ser su objeto y su método) adoptando una perspectiva basada en la genealogía de cuño foucaultiano y en la antropología de la ciencia de autores como Bruno Latour. Para ello, se marca distancia con la llamada Psicología crítica y se argumenta que la Psicología importa más por lo que hace que por lo que dice (aunque decir es también hacer) y que funciona ante todo como una práctica de subjetivación. Se termina revisando brevemente algunos trabajos que intentan mostrar ese funcionamiento en casos concretos

A conception of psychology is tentatively proposed which aims to displace epistemological questions (what kind of science it is, if it is a science) and theoretical and methodological questions (what its object and its method should be). Instead, a perspective is adopted that is based on Foucauldian genealogy and the anthropology of science by authors such as Bruno Latour. An attempt is made to create distance with respect to so-called critical psychology. It is argued that psychology matters more for what it does than for what it says (although saying is also doing) and that it functions mainly as a practice of subjectivation. This paper ends by briefly reviewing a number of works that attempt to show this functioning in specific cases

Cross-Cultural Validation of the Polish Version of the ADI-R, Including New Algorithms for Toddlers and Young Preschoolers.

Autism Diagnostic Interview-Revised (ADI-R) is one of the most widely used standardized diagnostic instruments for autism spectrum disorder (ASD). This article presents findings from the validation of the Polish version of the Autism Diagnostic Interview-Revised (ADI-R-PL), including new algorithms for toddlers and preschoolers. The validation group consisted of 125 participants: 65 with Autism Spectrum Disorder (ASD group) and 60 in the control group, including individuals with non-ASD disorders and typical development. The normalization group consisted of 178 participants, including 118 with ASD. The ADI-R-PL was found to have good psychometric properties. Confirmatory factor analysis supported both a bifactor structure and three-factor model. The study has generated preliminary information about the psychometric properties of the new algorithms for toddlers and young preschoolers. To the best of our knowledge, this paper is the first to propose new cutoffs in three ADI-R domains for a non-English-speaking population.

The Association Between Anhedonia, Suicide Ideation, and Suicide Attempts: A Replication in a Persian Student Sample.

Research suggests that anhedonia, a common symptom of depression, may be uniquely associated with suicidal behavior. However, little research has examined this association across cultures. To address this limitation, this study attempted to replicate a recent anhedonia and suicide study (conducted in a western culture) in a Persian sample using the Specific Loss of Interest and Pleasure Scale, Persian version. Participants consisted of 404 students who were recruited from a Persian university. Surprisingly, our results indicated that anhedonia levels were more than double those found in similar American student sample. Despite this marked difference in anhedonia symptoms, we found that anhedonia was associated with suicide risk, even when it was statistically accounting for other depressive symptoms. These findings suggest that anhedonia is a robust predictor of suicide risk across these two cultures. Further, anhedonia may be a particularly important treatment target among Persian students.

Cultural responses towards the aftermath of suicide among the Acholi in Northern Uganda.

BACKGROUND: Suicide is a public health problem in Uganda among indigenous societies, and different societies manage its aftermath differently. AIM: To explore how the Acholi in Northern Uganda manage the aftermath of suicide. METHODS: We conducted a qualitative study in Gulu district, a post-conflict area in Northern Uganda. We conducted a total of four focus group discussions (FGDs) and 12 key informant (KI) interviews. KI interviews were conducted with community leaders, while the FGDs were conducted with members of the general population. We analysed the data by means of Grounded Theory. RESULTS: Our findings indicate that rituals form a large part in managing suicide among the Acholi. Study communities practised distancing (symbolically and physically) as a way of dealing with the threat of suicide. CONCLUSION: Distancing was organized into two broad themes: affect regulation and securing future generations. It is recommended that public health interventions should utilize cultural institutions in the prevention of suicide.

Race, alcohol and general paralysis: Emil Kraepelin's comparative psychiatry and his trips to Java (1904) and North America (1925).

This article examines Emil Kraepelin's notion of comparative psychiatry and relates it to the clinical research he conducted at psychiatric hospitals in South-East Asia (1904) and the USA (1925). It argues that his research fits awkwardly within the common historiographic narratives of colonial psychiatry. It also disputes claims that his work can be interpreted meaningfully as the fons et origio of transcultural psychiatry. Instead, it argues that his comparative psychiatry was part of a larger neo-Lamarckian project of clinical epidemiology and was thus primarily a reflection of his own long-standing diagnostic practices and research agendas. However, the hospitals in Java and America exposed the institutional constraints and limitations of those practices and agendas.

Suicide in Nepal: Qualitative Findings from a Modified Case-Series Psychological Autopsy Investigation of Suicide Deaths.

South Asia accounts for the majority of the world's suicide deaths, but typical psychiatric or surveillance-based research approaches are limited due to incomplete vital surveillance. Despite rich anthropological scholarship in the region, such work has not been used to address public health gaps in surveillance and nor inform prevention programs designed based on surveillance data. Our goal was to leverage useful strategies from both public health and anthropological approaches to provide rich narrative reconstructions of suicide events, told by family members or loved ones of the deceased, to further contextualize the circumstances of suicide. Specifically, we sought to untangle socio-cultural and structural patterns in suicide cases to better inform systems-level surveillance strategies and salient community-level suicide prevention opportunities. Using a mixed-methods psychological autopsy approach for cross-cultural research (MPAC) in both urban and rural Nepal, 39 suicide deaths were examined. MPAC was used to document antecedent events, characteristics of persons completing suicide, and perceived drivers of each suicide. Patterns across suicide cases include (1) lack of education (72% of cases); (2) life stressors such as poverty (54%), violence (61.1%), migrant labor (33% of men), and family disputes often resulting in isolation or shame (56.4%); (3) family histories of suicidal behavior (62%), with the majority involving an immediate family member; (4) gender differences: female suicides were attributed to hopeless situations, such as spousal abuse, with high degrees of social stigma. In contrast, male suicides were most commonly associated with drinking and resulted from internalized stigma, such as financial failure or an inability to provide for their family; (5) justifications for suicide were attributions to 'fate' and personality characteristics such as 'stubbornness' and 'egoism'; (5) power dynamics and available agency precluded some families from disputing the death as a suicide and also had implications for the condemnation or justification of particular suicides. Importantly, only 1 out of 3 men and 1 out of 6 women had any communication to family members about suicidal ideation prior to completion. Findings illustrate the importance of MPAC methods for capturing cultural narratives evoked after completed suicides, recognizing culturally salient warning signs, and identifying potential barriers to disclosure and justice seeking by families. These findings elucidate how suicide narratives are structured by family members and reveal public health opportunities for creating or supplementing mortality surveillance, intervening in higher risk populations such as survivors of suicide, and encouraging disclosure.

Selected psychiatric problems among college students in two Arab countries: comparison with the USA.

BACKGROUND: Psychiatric problems among college students on USA campuses are common. Little is known about similar problems in developing countries, particularly the Arab region. The goal of this study was to assess the frequency of selected psychiatric problems among college students in two Arab countries: Qatar and Lebanon, and to compare them to the USA. METHODS: The Healthy Minds Study, an online confidential survey of common psychiatric symptoms designed for college campuses was used. We used the Patient Health Questionnaire-9 (PHQ-9) to screen for major depression, the Generalized Anxiety Disorder-7 (GAD-7) to screen for generalized anxiety and the SCOFF questionnaire to screen for eating disorders. Comparisons were made using ANOVA, Chi-Square tests and logistic regressions. RESULTS: A total of 1841 students participated in the study. The rates of depression (PHQ-9 ≥ 12), generalized anxiety (GAD-7 ≥ 10) and eating disorders (SCOFF≥3) at the combined Arab universities were 34.6, 36.1 and 20.4% respectively. The corresponding rates in the USA were: 12.8, 15.9 and 6.8% (p < 0.001 for all measures). The impact of psychiatric problems on functioning in general and academic performance in particular was more severe in the Arab countries compared to the USA (p < 0.001). Independent predictors of psychiatric problems in general included location, female gender, financial difficulties and poor grades. Being religious had a protective association with mental health. CONCLUSION: The rates of depression, anxiety and eating disorders were significantly higher among college students in Qatar and Lebanon compared to the USA. Additional research is needed to determine whether these results reflect methodological limitations or true differences in psychopathology across these populations. If replicated, the results indicate that the psychiatric problems on college campuses in the USA are a microcosm of a global problem that needs global solutions.

Cultural concealment and therapy outcomes.

Therapy is predicated on the need for clients to share intimate details about their lives, including their cultural values, attitudes, and beliefs. Previous studies have found that clients conceal certain aspects of their lives including, but not limited to their symptoms and their feelings about the therapy process. To date, there has not been an investigation focused on whether clients conceal aspects of their cultural identities, whether some therapists are more likely to have clients conceal aspects of their cultural identities, and if cultural concealment is associated with therapy outcomes. The present study attempted to do so utilizing the caseloads of 37 therapists who treated a total of 233 clients in a university counseling center setting. Client data were collected at the end of treatment utilizing the Patient's Estimate of Improvement (PEI; Hatcher & Barends, 1996), a measure that assesses client change on domains including general functioning, symptom related distress, intimate and social relationships, work or school, feelings about oneself, behavior, control of life, and tolerance for and ability to share painful feelings. Cultural concealment was assessed via 5 items regarding the amount and circumstances under which clients withheld cultural identity based information in therapy. Results indicated that within therapists' caseloads, client's ratings of cultural concealment were negatively associated with therapy outcomes. Additionally, therapists whose clients rated more cultural concealment on average had clients with worse therapy outcomes. Lastly, there was a significant contextual effect indicating that within and between therapist cultural concealment were statistically different from one another. (PsycINFO Database Record

The mediating role of cultural coping behaviours on the relationships between academic stress and positive psychosocial well-being outcomes.

While culture's effect on the coping process has long been acknowledged in the stress-coping literature conceptually, empirical evidence and attempts to discern the specific relationship between culture and coping remain very scarce. Against this backdrop, the present study applied the Cultural Transactional Theory (Chun, Moos, & Cronkite, 2006) to examine the mediating role of cultural coping behaviours (Collective, Engagement and Avoidance Coping) on the relationship between academic stress (AS) and two positive psychosocial well-being outcome measures: Collective Self-esteem (CSE) and Subjective Well-being (SWB). Responses from a sample of undergraduate students in Canada (N = 328) were analysed to test a theory-driven, hypothesised model of coping using structural equation modelling (SEM). As hypothesised, the SEM results showed that: (a) the proposed cultural coping model fit the data well; (b) Engagement Coping and Collective Coping partially mediated the association between AS and the outcomes and (c) the path relationships among the constructs were in the hypothesised directions. A set of preliminary exploratory analyses indicated that Collective Coping was most strongly endorsed by the African/Black and the Middle Eastern cultural groups as compared to other ethnic groups. Implications of the study's findings for future research and practice concerning culture, stress, and coping are discussed.

A feitura do santo: percursos desenvolvimentais de médiuns em iniciação no candomblé / "a feitura do santo": itinerarios de desarollo de médiums en iniciación en el candomblé / "a feitura do santo": developmental courses of mediums in candomblé initiation

Resumo O objetivo deste estudo foi compreender os processos desenvolvimentais de pessoas que atuam como médiuns em comunidades de matrizes africanas. Participaram 12 médiuns que já realizaram a feitura do santo, ou seja, o processo de iniciação no candomblé. Foi empregado o modelo bioecológico em interface com a etnopsicologia. A feitura do santo proporciona remanejamentos identitários que interferem em outros microssistemas. O respeito extremo à hierarquia é valorizado e está associado à realização de obrigações, provendo saberes e experiências a serem compartilhados com o decorrer do tempo. Portanto, são diversas as transformações subjetivas que o processo de feitura do santo pode proporcionar e suas repercussões parecem extrapolar a vida do médium, promovendo o desenvolvimento daqueles com quem ele se relaciona.

Resumen El objetivo de este estudio fue comprender los procesos de desarrollo de personas que actúan como médiums en comunidades de matrices africanas. Participaron 12 médiums que ya realizaron la "feitura do santo", o sea, el proceso de iniciación en el Candomblé. Se empleó el modelo bioecológico en interfaz con la etnopsicología. La "feitura do santo" proporciona desplazamientos identitarios que interfieren en otros microsistemas. El respeto extremo a la jerarquía es valorado y está asociado a la realización de obligaciones, proveyendo saberes y experiencias a ser compartidos con el transcurrir del tiempo. Por lo tanto, son diversas las transformaciones subjetivas que el proceso de elaboración del santo puede proporcionar, y sus repercusiones parecen extrapolar la vida del médium, promoviendo el desarrollo de aquellos con quienes se relaciona.

Abstract The objective of this study was to comprehend the developmental processes of people who act as mediums in communities of African matrices. Twelve mediums who have already performed the process of the religious ceremony of initiation called feitura de santo in Candomblé participated. The bioecological model was used in interface with ethnopsychology. The religious ceremony of initiation called feitura de santo provides identity shifts that interfere with other microsystems. Extreme respect for the hierarchy is valued and associated with the fulfillment of obligations, providing knowledge and experience to be shared over time. Therefore, there are several subjective transformations that the process of feitura de santo can provide and its repercussions seem to extrapolate the life of the medium, promoting the development of those with whom he relates.

Lifetime prevalence of mental disorders among first and second generation individuals with Turkish migration backgrounds in Germany.

BACKGROUND: This paper focuses on the lifetime prevalence of mental disorders in individuals with Turkish migration backgrounds in Germany, as there is a lack of reliable epidemiological data on this subject. METHODS: In total, 662 adults with Turkish migration backgrounds were interviewed in Hamburg and Berlin by trained, bilingual interviewers using the computerized Composite International Diagnostic Interview (CIDI DIA-X Version 2.8) to assess diagnoses according to the DSM-IVTR. RESULTS: The analyses showed a weighted lifetime prevalence of 78.8% for any mental disorder, 21.6% for more than one and 7.3% for five or more disorders. Any mood disorder (41.9%), any anxiety disorder (35.7%) and any somatoform disorder/syndrome (33.7%) had the highest prevalences. Despite the sociodemographic differences between the first and second generations, there were no significant differences in the lifetime prevalence between generations, with the exception of any bipolar disorder. Female gender, older age and no current partnership were significantly associated with the occurrence of any mood disorder. CONCLUSIONS: Overall, the results indicate a high lifetime prevalence in individuals with Turkish migration backgrounds in Germany. These initial data are highly relevant to the German clinical and psychosocial healthcare system; however, the methodological limitations and potential biases should be considered when interpreting the results.