CULTURAL FACTORS IN DEPRESSION AND COMORBID DRINKING

抑郁症和共病饮酒的文化因素

• 批准号: 2675426
• 负责人: THERESA D. O'NELL
• 金额: $ 3.71万
• 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 1998-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/2675426
• 关键词: CULTURAL; FACTORS; DEPRESSION; COMORBID; DRINKING

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，提出了 一项研究考察了影响抑郁障碍的文化和社会因素 青少年、成年人和老年人中的饮酒问题 生活在北部平原保留地的美洲印第安人。 具体地说，该项目的目标包括：1)民族志探索 有类似抑郁经历的当地迹象，有问题的酒精 使用，以及它们的共同发病，特别关注文化习语和 解释性模型和DSM-IV标准的文化相关性 每个综合症；2)亚文化变异的民族志调查 在文化习语和解释模式的日常使用中 抑郁和问题饮酒按性别和跨青年、中年 成人期和成年期；以及3)对 三者症状表现病理的文化界定 样本--青少年、成年人和老年人被诊断为重大疾病的样本 抑郁障碍按DSM-IV标准，样本构成 并以类似的方式被诊断为酗酒或依赖 以类似的方式构成和诊断的样本，与 既有酗酒也有严重的抑郁障碍。 这项研究立足于人类学和精神病学 概念化的人类无序，会产生丰富而又具有可比性 一组数据，包括：1)人种学报告，详细说明 当代保留生活；2)与20名治疗师的采访记录 关于a)文化特有的症状、习语和解释模式 抑郁症和问题饮酒；以及b)需求侧管理的文化相关性 抑郁障碍和酒精障碍的标准；3)民族志 关于三个年龄段的男性和女性角色期望的报告 以及它们与理解的体验和表达的关联性 精神病理学；4)关于正常评估的民族志笔记 以及日常生活中的异常情绪和饮酒；5)一套 与大约30名未确诊的、自我诊断的人种学访谈 选定的受访者；以及6)一组三次访谈(CIDI、SCID和 随机抽取的72名受访者中的每一人)。 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 这两种人类痛苦的视觉的相互联系，研究结果将 为跨文化精神病学领域做出贡献 以及理论上意义重大的方法。在这项研究完成后， 菲尔德将准备将这些理解应用于 更具文化敏感性的诊断措施和干预措施 作为更好的流行病学和服务利用手段 美国印第安人。此外，由于文化在精神病理学中的作用是 更好地理解，跨越障碍，跨越一生，跨越 文化，我们将能够设计出更好的研究 关注精神和情绪障碍的社会性质。