A cross-cultural interpersonal model of adolescent depression: A qualitative study in rural Nepal.
A cross-cultural interpersonal model of adolescent depression: A qualitative study in rural Nepal.
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DOI：
10.1016/j.socscimed.2020.113623
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发表时间：
2021-03
期刊：
影响因子：
--
通讯作者：
Kohrt BA
中科院分区：
文献类型：
--
作者：
Rose-Clarke K;Hassan E;Bk P;Magar J;Devakumar D;Luitel NP;Verdeli H;Kohrt BA
大多数关于抑郁症的跨文化定性研究都是描述性的，记录症状和解释模型。缺乏对抑郁症理论模型的定性研究检验。人际关系模式将悲伤、人际纠纷、角色转换和社会孤立作为抑郁症发生的背景，是人际治疗(IPT)的基础，在跨文化环境中，人际治疗越来越多地用于治疗抑郁症。我们的目的是定性地评估人际关系模式在多大程度上可以解释尼泊尔的青少年抑郁。数据收集于2018年12月至2019年4月期间，包括126名参与者的成绩单：对13-18岁抑郁青少年的25次半结构化访谈；与青少年的4次焦点小组讨论(N=438)，与父母/照顾者的4次讨论(N=39)，与教师的2次(N=0.17)；以及对卫生和非政府组织工作人员的7次半结构化访谈。我们使用一个分析框架对数据进行编码，该框架包括演绎代码，这些代码代表了抑郁症和IPT的人际模型中的关键概念，包括原则、技术和策略。参与者主要将抑郁与悲伤、争执、角色转换和社会孤立等人际问题领域联系起来。人际纠纷很常见，对许多青少年来说，这涉及父母的身体和精神虐待。尽管角色转换很常见，但很少有青少年为失去以前的角色而悲伤。尽管与家庭和社区成员有密切的身体接触和广泛的社会互动，但与社会隔离有关的痛苦是显而易见的。青少年描述的应对策略类似于IPT的核心策略，例如识别有益和不利的关系，并产生管理问题的选择和方法。总而言之，人际关系问题与这一人群相关，概念化与抑郁症人际模型的核心原则一致。这些发现强调了在抑郁症病因学中解决虐待和虐待问题的重要性。它们还为尼泊尔及其他地区未来IPT的文化适应提供了信息，包括整合当地应对战略的机会。跨文化测试心理模型对于适应疗法很重要。在尼泊尔，人际关系问题会引发青少年抑郁。抑郁的经历与人际治疗(IPT)的核心原则一致。很少有青少年使用IPT策略来解决人际问题。抑郁症的模型必须将贫困、移民和虐待作为风险因素。
Most cross-cultural qualitative research on depression has been descriptive, documenting symptoms and explanatory models. There is a lack of qualitative research testing theoretical models of depression. The interpersonal model conceptualises grief, interpersonal disputes, role transitions and social isolation as the context in which depression develops and is the basis of interpersonal therapy (IPT), which is increasingly used in cross-cultural settings to treat depression. We aimed to qualitatively evaluate to what extent the interpersonal model can explain adolescent depression in Nepal. Data were collected between December 2018 and April 2019 and comprised transcripts from 126 participants: 25 semi-structured interviews with depressed adolescents aged 13–18; four focus group discussions with adolescents (N = 38), four with parents/caregivers (N = 39), and two with teachers (N = 17); and seven semi-structured interviews with health and non-governmental organisation workers. We coded data using an analytical framework comprising deductive codes representing key concepts from the interpersonal model of depression and IPT, including principles, techniques and strategies. Participants mainly related depression to interpersonal problem areas of grief, dispute, role transition and social isolation. Interpersonal disputes were common, and for many adolescents this involved parental physical and emotional abuse. Although role transitions were common few adolescents grieved loss of the prior role. Distress related to social isolation was evident despite close physical proximity and extensive social interaction with family and community members. Adolescents described coping strategies that were similar to strategies central to IPT, e.g. identifying helpful and unhelpful relationships and generating options and ways of managing problems. In conclusion, interpersonal problems are relevant to this population and conceptualisations align with core principles of the interpersonal model of depression. The findings highlight the importance of addressing abuse and maltreatment in depression aetiology. They also inform future cultural adaptations of IPT in Nepal and beyond, including the opportunity to integrate local coping strategies. Testing psychological models cross-culturally is important for adapting therapies. Interpersonal problems trigger depression among adolescents in Nepal. Experiences of depression align with core principles of interpersonal therapy (IPT). Few adolescents use IPT strategies to address interpersonal problems. Models of depression must incorporate poverty, migration and abuse as risk factors.
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影响因子：
120.7
作者：
Bolton, P;Bass, J;Weissman, M
通讯作者：
Weissman, M
影响因子：
4
作者：
Gale NK;Heath G;Cameron E;Rashid S;Redwood S
通讯作者：
Redwood S
影响因子：
8.1
作者：
Gao, Ling-ling;Chan, Sally Wai-chi;Hao, Yuantao
通讯作者：
Hao, Yuantao
DOI：
10.1097/01.chi.0000237705.43260.2c
发表时间：
2006-12-01
影响因子：
13.3
作者：
Cohen, Judith A.;Mannarino, Anthony P.;Staron, Virginia R.
通讯作者：
Staron, Virginia R.
DOI：
10.1111/j.1469-7610.1981.tb00533.x
发表时间：
1981-01-01
影响因子：
7.6
作者：
BIRLESON, P
通讯作者：
BIRLESON, P