COMPARATIVE CULTURAL STUDY OF PSYCHIATRIC ILLNESS

为跨文化研究开发可推广的方法论 健康问题，有能力解决被忽视但至关重要的问题 国际精神病学和美国少数民族心理健康 美国一直是一项研究议程的首要主题 由NIMH职业发展奖(RSDA，1级)支持。在……里面 这是一项关于麻风和精神健康的文化研究，该研究 制作了一种新的工具，将流行病学和 人类学框架--解释模型视域 对于-，分类(EMIC)。EMIC将被改装为启动 精神疾病相关疾病信念和行为的研究 海地移民问题。拟议的研究“将 开发技术来分析和比较来自这两者的数据 样本，每个样本本身都很重要，并通过它们的作用联系在一起 在发展这一方法论方面。麻风病仍然是主要的热带疾病 许多发展中国家的疾病。作为终极隐喻， 耻辱和绝望，它体现了健康问题 改善精神病学和医学之间的联系可能会减少 显著的情感负担和增强的有效性 医疗服务。这项研究将澄清精神病学、后遗症 并阐明可能对麻风产生不利影响的文化意义 遵守防止畸形的根治治疗。 基于这一经验，拟议的研究将证明 EMIC可以可靠地与SCID一起使用，并且 汉密尔顿抑郁和焦虑联合评定量表。这 研究验证了这一假设，即利用的限制 和印度主流卫生服务的有效性，a 有代表性的发展中国家，以及#年海地移民中 美国，一个相当大的少数民族，在文化上与 基于疾病的信念和行为。使用连贯的框架 它建立在Arthur Kleinman的解释模型理论和 纳入与以下方面相关的诊断评估的进展 斯皮策、恩迪科特、罗宾斯等人，这项研究将会发展 比较文化、疾病之间关系的技巧 信仰、患病行为、临床病程和结局。经验 在目前的研究中将指导计划进行更大样本的研究 并支持比较技术的开发 对其他地方用类似方法得出的数据的分析。

Developing a generalizable methodology for cross-cultural study of health problems, capable of addressing neglected but vital issues in international psychiatry and minority mental health in the United States, has been the overarching theme of a research agenda supported by an NIMH career development award (RSDA, Level 1). In a cultural study of leprosy and mental health, the research has produced a new instrument that integrates epidemiological and anthropological frameworks, the Explanatory Model Inter-view for-,Classification (EMIC). The EMIC will be adapted to initiate a study of illness beliefs and behavior associated with psychiatric problems of Haitian immigrants. The proposed research " will develop techniques to analyze and compare data from these two samples, each significant in its own right and linked by their role in developing this methodology. Leprosy remains a major tropical disease in many developing countries. As the ultimate metaphor for stigma and despair, it exemplifies health problems for which improving links between psychiatry and medicine may reduce a significant emotional burden and enhance the effectiveness of medical services. This research will clarify psychiatric, sequelae of leprosy and elucidate cultural meanings that may adversely affect compliance with curative treatment that prevents deformities. Building on that experience, the proposed research will demonstrate that the EMIC can be used reliably in conjunction with the SCID and combined Hamilton depression and anxiety rating scales. This research tests the hypothesis that limitations in the utilization and effectiveness of mainstream health services in India, a representative developing country, and among Haitian immigrants in the United States, a significant minority, are related to culturally based illness beliefs and behaviors. Using a coherent framework that builds upon the explanatory model theory of Arthur Kleinman and incorporating advances in diagnostic assessment associated with Spitzer, Endicott, Robins and others, this study will develop techniques to compare relationships between culture, illness beliefs, illness behavior, clinical course and outcome. Experience in the current research will guide plans to study a larger sample and support the development of techniques for the comparative analysis of data derived by similar methods elsewhere.