CULTURAL FACTORS IN DEPRESSION AND COMORBID DRINKING

抑郁症和共病饮酒的文化因素

• 批准号: 2416146
• 负责人: THERESA D. O'NELL
• 金额: $ 8.3万
• 依托单位: UNIVERSITY OF COLORADO DENVER
• 依托单位国家: 美国
• 财政年份: 1996
• 资助国家: 美国
• 起止时间: 1996-05-01 至 2001-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/2416146
• 关键词: Native Americans; alcoholic beverage consumption; alcoholism /alcohol abuse; clinical depression; clinical research; comorbidity; culture; expectancy; human subject; mental disorder diagnosis; mental health epidemiology; racial /ethnic difference; role

Drawing from concepts and methods in medical anthropology, the proposed study examines cultural and social factors affecting depressive disorder and problem drinking among the adolescents, adults, and elderly of an American Indian people living on a Northern Plains reservation. Specifically, the project aims include: 1) an ethnographic exploration of the local signs of depressive-like experiences, problematic alcohol use, and their co-morbidity, with a special focus on cultural idioms and explanatory models, and the cultural relevance of DSM-IV criteria for each syndrome; 2) an ethnographic investigation of subcultural variation in the everyday use of cultural idioms and explanatory models for depression and problem drinking by gender and across youth, middle adulthood and older adulthood; and 3) an appraisal of the influence of cultural definitions of pathology on symptom presentation among three samples -- a sample of youths, adults and elderly diagnosed with major depressive disorder according to DSM-IV criteria, a sample constituted and diagnosed in a similar fashion with alcohol abuse or dependence, and a sample constituted and diagnosed in a similar fashion as comorbid with both an alcohol and a major depressive disorder. This study, anchored in both anthropological and psychiatric conceptualizations of human disorder, will produce a rich and comparative set of data that will include: 1) ethnographic reports detailing contemporary reservation life; 2) interview transcripts with 20 healers about a) culture-specific syndromes, idioms and explanatory models for depression and problem drinking; and b) the cultural relevance of DSM criteria for depressive disorders and alcohol disorders; 3) ethnographic reports about role expectations for men and women across three age-grades and their relevance for understanding the experience and expression of psychopathology; 4) ethnographic notes regarding assessments of normal and abnormal affect and drinking in everyday contexts; 5) a set of ethnographic interviews with approximately 30 non-diagnosed, self- selected respondents; and 6) a set of three interviews (CIDI, SCID, and ethnographic) for each of 72 randomly selected respondents. Through a rigorous investigation of cultural definitions of psychopathology, their relationships to diagnostic criteria, and the interrelation of these two visions of human distress, the findings will contribute to the field of cross-cultural psychiatry in both practically and theoretically significant ways. By the completion of this study, the field will be poised to apply these understandings to the development of more culturally-sensitive diagnostic measures and interventions, as well as better epidemiological and service utilization instruments for American Indians. Moreover, as the role of culture in psychopathology is better understood, across disorders, across the life-span, and across cultures, we will be in the position to design better research that attends to the social nature of mental and emotional disorder.

借鉴医学人类学的概念和方法， 一项研究探讨了影响抑郁症的文化和社会因素 青少年、成年人和老年人的饮酒问题 生活在北方平原保留地的美洲印第安人。 具体而言，该项目的目标包括：1）民族志探索 当地的抑郁症状，酗酒， 使用，及其共病，特别侧重于文化习语， 解释模型，以及DSM-IV标准的文化相关性， 2）亚文化差异的人种学调查 在日常使用的文化习语和解释模型， 抑郁症和酗酒问题，按性别和青年， 成年期和老年期; 3）评估 病理学对症状表现的文化定义 样本-一个被诊断患有主要疾病的青年、成年人和老年人的样本 抑郁症根据DSM-IV标准，样本构成 并以类似的方式被诊断为酒精滥用或依赖， 以与共病相似的方式构成和诊断的样品 酗酒和重度抑郁症 这项研究以人类学和精神病学为基础， 人类混乱的概念化，将产生一个丰富的和比较 一组数据，将包括：1）人种学报告，详细说明 当代保留地生活; 2）与20名治疗师的访谈记录 关于a）特定文化的综合征，习语和解释模型， 抑郁症和问题饮酒;和B）DSM的文化相关性 抑郁症和酒精障碍的标准; 3）人种志 关于三个年龄段男女角色期望的报告 以及它们对于理解人类的经验和表达的意义 精神病理学; 4）关于正常人评估的人种学笔记 和异常情绪和饮酒在日常环境中; 5）一套 对大约30名未经诊断的自我诊断的人进行了人种学访谈， 选定的受访者;和6）一组三个访谈（CIDI，SCID， 随机选择72名受访者。 通过对文化定义的严格调查， 精神病理学，它们与诊断标准的关系，以及 这两种对人类苦难的看法的相互关系，研究结果将 为跨文化精神病学领域做出贡献， 和理论上重要的方法。本研究完成后， 该领域将准备将这些理解应用于开发 对文化更加敏感的诊断措施和干预措施，以及 作为更好的流行病学和服务利用工具， 美洲印第安人此外，由于文化在精神病理学中的作用， 更好地理解，跨越疾病，跨越生命周期，跨越 文化，我们将能够设计更好的研究， 关注精神和情感障碍的社会性质。