Somatosphere welcomes you to the March edition of “In the Journals.” Scroll through our monthly round up of new research across anthropology, STS and social science journals.
Hormonal stories: a new materialist exploration of hormonal emplotment in four case studies
Sonja Erikainen, Andrea Ford, Roslyn Malcolm, Lisa Raeder
Hormones are complex biosocial objects that provoke myriad cultural narratives through their association with social activities and identities, and these narratives have the power to shape people’s lived realities and bodies. While hormones were historically conceptualised as ‘master molecules’ capable of controlling various life processes, their explanatory potential has now been overshadowed by technoscientific developments like omics- and gene-based biotechnologies that have reframed how human bodies and behaviours are understood. Considering these shifts, this paper asks what roles hormones perform and what stories they are arousing today. Through a patchwork of four hormone stories about contraception, gender hacking, birth, and autism-specific horse therapy, we show how hormones remain vital protagonists in the constitution of bodies, affects, environments, places, politics, and selves in the contemporary period. Building on new materialist approaches, we adopt and extend the notion of ‘emplotment’ to encapsulate how hormones act as key characters in our plots. They are working to complicate dominant understandings of what bodies are and can be in new ways as they mediate different plots of bodily experience, in ways showing the ongoing powerful salience of hormones and their ascendancy in the present.
Laura Louise Heinsen
In Denmark, pregnant persons have a statutory right to abortion on-demand in the first trimester of pregnancy, after which abortion must be sanctioned by a regional abortion committee and may be warranted if there is danger that the fetus will suffer a serious mental or physical disability, yet what precisely constitutes ‘danger’ and ‘seriousness’ are left in the hands of the juridical abortion system to interpret. In this article, I explore how jurists and doctors arrive at and legitimate the authorization of disability-selective abortion. Building on van Wichelen’s (Legitimating life: adoption in the age of globalization and biotechnology, Rutgers University Press, New Brunswick, 2019) concept of ‘legitimation work,’ I show how abortion committees make legal decisions by dividing and distributing the task of —and moral responsibility for—making life-ending decisions by leaning on established legal practice, what I refer to as bureaucratic legitimation work; risk estimates made by external medical experts, what I refer to as collaborative legitimation work; and the ethical panacea of individual autonomy and informed choice, what I refer to as ethopolitical legitimation work. I argue that in conjunction, these forms of legitimation work turn termination of almost every non-conforming fetus into legitimate acts, hereby safeguarding ableist family formation.
Alberto Aparicio
Researchers in xenobiology, a subdiscipline of synthetic biology, aim to build a ‘second nature’ with nucleic acid analogues, termed Xeno-nucleic acids (XNA). They promise biosafe technologies, based on the impossibility of transferring genetic material to other organisms and controlling the proliferation of genetically modified microorganisms. Proponents of xenobiology have employed metaphors and narratives that represent the separation of synthetic life from DNA-based, constituting a safer space for the exploration and navigation of virtual biological worlds. Based on interviews with synthetic biologists and participant observation in a synthetic biology laboratory, I argue that the reconfiguration of nature that xenobiologists seek is inspired by the vision of design and governance laid out in the 1975 Asilomar conference, so normative aims of safety are co-produced with visions of unnaturalness. I interrogate the types of limits that xenobiologists aim to cross, to propose that they conceive limits as pushing beyond what is biologically plausible, finding the challenge motivating. I show that the division between the natural and the unnatural is not clearly established as xenobiologists portray. In giving priority to safety as the determinant of the permissibility of new technologies, who gets to define nature and its limits remains restricted to scientists.
Inscrutable futures: biotechnology, architecture, and planetary ecology in late industrial China
Eben Kirksey, Aaron Su
The future is becoming inscrutable in Shenzhen, a city in southern China, despite efforts by biotechnologists to make life predictable and subject to control. Bubbles of speculation burst in 2018, as scandals disrupted local biotech ventures and as buildings were ripped apart by hostile atmospheric conditions. This article places the controversial CRISPR gene editing experiment conducted by Dr. He Jiankui, that resulted in the birth of the world’s first genetically modified children, in the context of Typhoon Mangkhut, the strongest storm to hit the region in nearly half a century. This superstorm destroyed architectural monuments to the exuberance of market capitalism, disrupted Dr. He’s plans at a critical moment in his entrepreneurial ventures, and surrounded dreams about creating synthetic life with accumulating rubble. Even as the elite envision spectacular futures in the storm’s aftermath—with architectural renderings, new biotech schemes, and state policies like the China Dream—we show that the future has become inscrutable for people working in marginalized economic sectors. A fish farmer, whose lifeworld was reduced to rubble by the typhoon, offers a clear vision of chaotic planetary futures from a perspective that is attuned to the heterogeneous temporalities of wild life.
Stephen Molldrem
Recent decades have seen expansions in the subfield of pathogen genomic epidemiology, also called ‘molecular epidemiology.’ Practitioners in this area analyze pathogen genetic sequence data to identify the emergence of pathogen subtypes or ‘variants,’ including ones that have evolved to have problematic biological characteristics such as greater transmissibility or treatment resistance. The field’s prominence has led to public controversies surrounding applications of pathogen genomics in disease control. The most highly visible examples occurred during the COVID-19 pandemic, when the designation of SARS-CoV-2 ‘Variants of Concern’ by the World Health Organization shaped public health strategies, media stories, and everyday talk about the pandemic. Drawing on several cases, I argue that controversies around uses of pathogen genomics have driven the emergence of a novel kind of socio-technical form, which I call a ‘molecular public.’ Molecular publics materialize when pathogen genomic science enters public discourse through news media or similar means, followed by people recognizing themselves as being potentially at risk of becoming infected with a particular pathogen subtype or affected by policy responses to a variant. I present molecular publics as a useful analytic for social studies of infectious disease and a vector through which novel biosocialities mediated by pathogens can emerge.
Harnessing the value of human bodily material: a bioconstitutional analysis
Hadrien Macq, Céline Parotte, Pierre Delvenne
Human tissues and cells are now recognized as an important source of health and wealth. As such, public authorities have assumed responsibility for regulating their procurement, storage and use. Looking at the interactions between law and life through the lens of ‘bioconstitutionalism’, we specifically ask how human bodily material (HBM) is regulated and explore the resulting changing relationships between citizens, public authorities and researchers in Belgium, a country where the pharmaceutical industry weighs heavily in terms of employment and economic growth. We examine the regulation of HBM and show how the Belgian bioconstitutional order increasingly promotes research by facilitating the availability and use of HBM in the hope that this will fuel the engine of innovation, employment, and economic growth. We argue that this represents a turnaround from traditional conceptions of biological citizenship, as the state’s demand that its citizens donate their HBM for research is reinforced. We emphasize that what it means to be “altruistic” is being reshaped within a new moral economy of donation, without a clear recognition of this reshaping: while citizens are crucial contributors to the development of the bioeconomy, they are excluded from participating in the governance of how this bioeconomy develops.
Anna Sofie Bach, Michala Hvidt Breengaard
In Denmark, as in many other countries, declining fertility rates have stimulated debates about ‘underpopulation’ as a threat to the nation’s future sustainability. At the same time, climate change has initiated debates about ‘overpopulation’ and ‘overconsumption’ as a problem for sustaining the planet. While both debates can be understood in terms of demographic anxieties placing sustainable reproductive futures’ central, they exhibit different ideas of what ‘sustainable’ entails. In this article, we analyze how sustainable reproduction is negotiated within agendas of respectively a national fertility crisis and the climate crisis. We do so by mapping the media debates in Denmark in the period between 2010 and 2022. The aim of the article is to contribute to an understanding of the repro-paradox which simultaneously calls upon young Danes to reproduce more and less.
Lise Eriksson
This article investigates 20 years of discursive struggles in Nordic medical journals around the process of legitimating and routinising gestational surrogacy and uterus transplantation in Finland and Sweden. The comparative analysis through critical discourse analysis suggests that influential health care professionals have contributed to different levels of legal and cultural adaptation of the methods, prioritising non-commercial gestational surrogacy in Finland and uterus transplantation in Sweden. The article identifies central discursive turning points in the medical journal discussions by interpreting them against the background of medical and policy developments in Finland and Sweden during the analysed twenty-year period. Legitimation and routinisation of surrogacy and uterus transplantation were developed through biomedicalisation by representing them as infertility treatments and emphasising the relational dynamics between donors and recipients—a connection that in the Nordic context is often based on kinship or close relationships. The diagnosis of absolute uterine factor infertility was central to representing women as on the boundary between fertile and infertile, as they may have functioning ovaries. Through the biomedicalised rhetoric of equal opportunities for biogenetic motherhood, the diagnosed women’s ambiguous reproductive status was used to legitimise the two methods as cures for absolute infertility, thereby reinforcing hegemonic family and kinship norms.
On Chainsaws and Acoustic Violence: Sound and Deforestation in Ajusco-Chichinautzin, Mexico
Andrew J. Green
This article explores distinct practices of sounding and listening that have emerged in a context of severe deforestation in Ajusco-Chichinautzin, a region south of Mexico City. It applies the concept of acoustic violence to this setting, as part of wider attempts to build constructive responses to climate breakdown through sound and music scholarship. As the first indication of occurring logging, the sound of chainsaws proves vital in attempts by forest guards and police to detect and halt deforestation. Equally, attentiveness to acoustic violence allows us to cut through sensationalist media presentations of the problem of deforestation, to perceive how local populations—often blamed for complicity with loggers—are in fact direct victims of environmental loss. The concept of acoustic violence can also illuminate how, in a context not just of environmental loss but of dispossession, modalities of listening may become simplified, instrumentalized, or lost.
Good Digestion: The Metabolic Politics of Dutch Dairy Farming
Else Vogel
In the Netherlands, what dairy cows eat, produce, and excrete is meticulously recorded and controlled. While farmers optimize cows’ diets for production, the side effects of this industrial metabolism have recently become problematized in new and strikingly public ways. Since 2019, the country has faced a so-called nitrogen crisis, a set of ecological, legal, and political challenges posed by nitrogen pollution from industrial activities, predominantly livestock farming. This article offers the concept of metabolic politics as a theoretical lens for understanding contestations over the power to organize more-than-human eating and feeding relations. Drawing on ethnographic fieldwork with veterinarians and farmers, I contrast governmental interventions in cows’ digestive processes with how bovine digestion is cared for on dairy farms. This reveals key features of metabolic politics: struggles over the forms of life that comprise the metabolic polis; clashing ways of valuing the health of organisms and ecosystems; and diverging styles of governing metabolic collectives.
Textures of care: Rethinking culture and therapeutic expertise in global psy
Nadia Augustyniak
How are psychotherapeutic approaches adapted and transformed in diverse contexts? This study situates the question in the global yet stratified field of psy knowledge production. Exploring the work of a group of psychological counselors in Sri Lanka, I theorize how such transformation takes shape at the intersection of explicit knowledge and tacit, embodied understanding through the concept of textures. Drawn from ordinary ethics and a phenomenological understanding of habit, the concept points to the felt qualities of interactions and the shared cultural sensibilities and ethical orientations they reflect. Focusing on the counselors’ discourse of “showing the way,” I illustrate how therapeutic practice may be textured, in this case, by forms of moral discernment that evoke Buddhist ethics and by a framing of distress that foregrounds the scene of the problem rather than the client’s emotional experience. I argue that attending to such textures of care makes it possible to deconstruct hierarchies of expertise and recognize forms of practice which appear to go against the grain of normative therapeutic frameworks as generative. This makes visible the diverse understandings of emotion, personhood, and well-being that localized forms of therapeutic practice engender within the contemporary, global psy imaginary.
What it is to see: Artificial vision as constitutive interaction
Cordelia Erickson-Davis MD PhD
Visual prosthesis (VP) devices—devices that electrically stimulate the visual system with the goal of restoring vision to individuals who have lost it—are the literal construal of the orthodox theory of vision that holds that perception is an “indirect” process. In this theory, vision is an image- and sensation-based reconstructive process of representation: a type of information processing that is medium-independent. In this article, I draw on four years of ethnographic research with both designers and users of VP devices to demonstrate that there are large discrepancies between expectations for these devices and actual recipient experiences. I argue that the failure of the devices stems in part from the problematic theory of vision that informed their design and implementation. I introduce an alternative theory of vision based on the work of empirical psychologist James J. Gibson that sees perception as the “direct” product of a constitutive interaction between a perceiver and environment in a perceiver-environment system. I show how a theory of perception as constitutive interaction (PCI) is more congruous with recipient reports and enables us to see that “artificial vision,” or the perceptual experience associated with the VP, is a unique perceptual phenomenon.
Health: An Interdisciplinary Journal for the Social Study of Health, Illness and Medicine
Lauren Bridgstock, Alison Pilnick, Sarah Goldberg, Rowan H Harwood
This paper examines how terms of endearment (ToE) are used as a mitigation device in interactions between staff and people living with dementia (PLWD) in the acute hospital environment. ToE are often discouraged in training for healthcare staff. However, this research demonstrates that they are still commonly used in practice. Using conversation analysis, video and audio data were examined to identify the interactional functions of ToE. Analysis showed that ToE play an important role in mitigating potentially face-threatening actions such as when patients are asked to repeat hard-to-interpret talk, or when patient agency is compromised through instruction sequences or having necessary healthcare tasks undertaken. The success of this mitigation is sensitive to the specific interactional circumstances, as well as the responsiveness of the HCP to the patient’s voiced concerns. These findings have implications for healthcare practice, training and wider care of PLWD.
Eleonora Rossero, Raffaella Ferrero Camoletto
Psychiatric practice has always entailed a coercive dimension, visible not only in its formal expressions (e.g. compulsory treatment) but in many informal and implicit forms. In fact, contemporary psychiatric practices are characterized by an interplay of coercion and dialog to be interpreted not as binary categories but as extremes of a spectrum. Within this perspective, it becomes crucial to draw boundaries attributing meaning to professional identities and practices in psychiatric work. This is particularly relevant in acute wards: to explore this issue, we selected two cases according to a most-different-cases design, one ward with a mechanical-restraint approach compared to one with no-mechanical-restraint. We argue that gender, mobilized to performatively draw distinctions and hierarchies in order to define and justify different approaches to psychiatric crises along the continuum between coercion and dialog, is a key dimension in the boundary-making process. The analysis identifies two main dimensions of drawing gendered boundaries: inter-gender boundaries (overlapping the binary distinction between masculinity and femininity with a more coercive or relational-dialogic approach to crisis) and intra-gender boundaries (distinguishing and ranking of different masculinities and femininities), associating a less coercive orientation with a devirilized masculinity.
Vibrant Screens: Remote therapy and counselling through the lens of digital materiality
Marjo Kolehmainen
This article analyses the digital screen as a health technology. In particular, the article asks how screens as a part of therapy settings or counselling practices materialise – or fail to materialise – care. The empirical data comprise interviews with therapy and counselling professionals, whose experiences with technology during the COVID-19 pandemic were my original interest. Adopting a sociomaterial approach to technology use, it scrutinises not only how screens are used, but also how screens themselves act and operate. This approach foregrounds the screen as ‘multiple’, complicating a dichotomous understanding between in-person therapy and remote therapy. The article argues that the screen operates in a variety of ways that might either facilitate or degrade care and is an essential part of more-than-human care in digitalised societies. Acknowledging the agential capacities of all matter, the article also conceptualises screens as ‘vibrant matter’.
Alvaro Martinez-Lacabe
Framed across three distinct periods of the history of neoliberalism and the HIV epidemic in England, this article conducts a detailed examination of the concept of personal responsibility and its contested uses within HIV prevention. The article questions the theoretical potential of neoliberal subjectivities to comprehend behaviours related to the pharmaceuticalised governance (or lack thereof) of gay men’s sexual health, exploring the gap between theories emphasising individual responsibility and the practical experiences of gay men. The analysis draws on testimonials from gay men in oral history interviews and archival sources. The article illustrates how the pervasive notion of personal responsibility in England has been co-opted by neoliberal ideologies, leading to the stigmatisation of gay men whose sexual behaviours diverge from public health mandates. The widespread stigmatisation resulting from this ideology underscores a significant limitation in the theoretical framework of neoliberal subjectivities. This constraint extends beyond merely failing to grasp the complexity of sexual behaviours; it also reflects a lack of understanding of any other behaviour related to public health. Therefore, the article concludes by advocating the necessity of employing and constructing alternative theoretical frameworks to comprehend the pharmaceutical governance or lack thereof of gay men’s sexual health. Through a concise autoethnography of the authors’ pharmaceutical sexual health governance, the article introduces the concept of biocommesuration as an illustrative analysis that transcends the limitations of neoliberal subjectivities.
Bright-siding stigma: Older adults’ experiences at a higher weight in Atlantic Canada
Andrea E Bombak, Norma Chinho, Lisa Thomson, Courtney Burk, Sumaiya Akhter, Kathleen O’Keefe, Lee Turner
The lived experiences of higher-weight people vary; homogenous samples may fail to capture this diversity. This study develops an in-depth understanding of the lived experiences of higher-weight (Body Mass Index ⩾ 30) older adults (⩾60 years of age) in a Canadian Atlantic province. Participants (n = 11) were interviewed face-to-face using a semi-structured interview guide twice at 2-to-3-month intervals regarding their perceived treatment in social and health situations; how positive and negative healthcare experiences affected their health, lifestyles and healthcare seeking-behaviour; and recommendations in terms of patient experiences, access and inclusion. Participants infrequently reported negative experiences; however, participants’ experiences were informed by uptake of moralistic, neoliberal discourses. Thematic content analysis identified two major themes: active citizenship (participants demonstrated internalisation of the imperative for weight loss, healthy lifestyles and active ageing) and bright-siding (participants expressed that a positive attitude could prevent/help cope with stigma). Results suggest that individualistic, rather than collective, political solutions to health and stigma have been taken up by higher-weight older adults in a Canadian Atlantic province, which may hinder attempts at structural reforms addressing stigma.
Dixi Louise Strand, Mari Holen
Patient and Public Involvement in Research (PPIR) has become an increasingly prevalent and integral part of biomedical research. In this paper, we focus on patient-led research, taking as our case the construction of new biomedical knowledge regarding the rare disease ADNP syndrome. Specifically, we seek to understand how concepts of experiential knowledge and lay expertise become integral to rather than separate from scientific expertise. In the case of ADNP, the parent-led research “mimes” biomedical knowledge practices in a way that, on the one hand, enhances the legitimacy of science and scientific expertise, and on the other displaces and transforms science by the fact that other knowledge agents (patients, next-of-kin) enter these practices.
When the basic seems like a luxury: Menstrual friendly public toilets in six cities
Sarah C. Blake, Kim J. Hopper, Angela-Maithy Nguyen, Andrew R. Maroko, Natalie Wyss, Elli Sugita, Natalia Fazzioni, Helen V.S. Cole, Marian Fe Theresa C. Lomboy, Ernesto R. Gregorio, Justine Bukenya Eva Polio, Marni Sommer
Public toilets are an important resource for securing gender equitable access to public space, but they are neglected across global contexts. This qualitative study explored the status, opportunities and challenges to creating menstrual friendly public toilets (MFPTs) in six cities: Barcelona, Kampala, Manila, New York City, Osaka, and Rio de Janeiro.
Jennifer W. Robinette, Jennifer A. Smith
In the US, racial/ethnic health disparities are undeniable. These disparities partially stem from residing in low socioeconomic neighborhoods, a circumstance to which racial/ethnic minorities are disproportionately exposed. Associations between socioeconomic status (SES) and health may have some underlying molecular mechanisms reflected in the epigenome. Yet, a growing body of research suggests that neighborhood characteristics are not experienced the same way for individuals from differing racial/ethnic backgrounds. The present study evaluated associations between area-based SES and epigenetic age as assessed by the Horvath, Hannum, PhenoAge, and GrimAge epigenetic clocks in a national sample of older non-Hispanic White, non-Hispanic Black, and Hispanic participants. The present study used epigenetic age data from 3790 participants in the 2016 wave of the Health and Retirement Study and census tract SES data from the 2012–2016 American Community Survey. Four epigenetic clocks were regressed on area-based SES, adjusting for age, sex, and educational attainment. Although area-based SES was not significantly associated with Horvath or Hannum clocks, living in lower SES census tracts was associated with older PhenoAge and GrimAge. After considering smoking status, however, only the association with GrimAge remained. Investigating interactions with race/ethnicity suggested that area-based SES was more strongly associated with accelerated Hannum, PhenoAge, and GrimAge among non-Hispanic White participants than for other racial/ethnic groups. These racial/ethnic differences were completely reduced, however, in models that included smoking status. The present results illuminated racially/ethnically distinct patterns of biological (epigenetic aging) and behavioral (smoking) risk for poor health, and suggested that ameliorating low area-based SES may be beneficial for racially/ethnically diverse populations.
Madeleine Patrick, Nicole Stephan, Thea Mink, Tanushree Bhan, Barbra Mary Aine, Nabutuwa Viola Matanda, Amelia Conrad, Sheela S. Sinharoy, Bethany A. Caruso
Menstruation has received growing attention in public health research, particularly among adolescents in schools. However, fewer studies have engaged adult men. This secondary analysis (1) assessed alignment between men’s perceptions of women’s menstruation practices and women’s actual practices; 2) examined associations between men’s demographic characteristics and their perception of menstruation-related communication norms, and 3) assessed if men’s perceptions of these norms are associated with their support of menstruating women or girls in their household.
Cross-sectional data were collected via household survey from men (n = 344) and women (n = 297) in Kampala, Uganda in 2022. Outcomes were two norms questions on the appropriateness of discussing menstruation in public and in front of men. We used a combination of Poisson and Firth’s regressions. Presence of a menstruator in the household was positively associated with men’s perception that it is acceptable to discuss menstruation in front of men (PR: 1.37; 95% CI: 1.07, 1.76; p < 0.01) or in public (PR: 1.12, 95% CI: 1.12, 2.46; p < 0.01). Supportive norms were associated with supportive behaviors; men who agreed that women may discuss menstruation in public and in front of men were more likely to report a willingness to talk to women about menstruation-related problems (PR = 1.75, 95% CI: 1.38, 2.22; p < 0.001). Our findings support the need for norms change to reduce stigma around discussing menstruation. Programs aiming to improve menstrual health should consider men’s knowledge of menstruation, their role in the household environment around menstruation, and how norms may contribute to how they support menstruators in their households.
Daming Lu, Mei-Po Kwan
Noise is a major global environmental issue that raises concerns about both mental and physical health. However, few studies have investigated the mediating role of emotions in the pathways linking noise exposure to health outcomes. Additionally, many studies have overlooked the varying effects of noise across different activity contexts. Most importantly, previous research has predominantly relied on correlational analysis, offering limited evidence of causality. In this study, we utilize real-time data from an environmental health survey of 800 residents in Hong Kong collected between 2021 and 2023 and apply a neural network-based Double Machine Learning model to estimate the pathways through which noise influences emotional states and health outcomes. Our findings reveal that (1) noise during travel significantly heightens real-time annoyance, while noise at home primarily increases real-time stress; (2) annoyance strongly contributes to headaches, whereas stress predominantly leads to insomnia and fatigue; and (3) noise at home directly triggers insomnia and fatigue, whereas noise during travel not only directly causes insomnia and headache but also indirectly exacerbates insomnia, fatigue, and headache through heightened annoyance. In contrast, noise in the workplace and outdoors has a limited impact on insomnia, fatigue, and headaches. This study provides valuable insights into the pathways through which noise influences negative emotional states and, subsequently, health outcomes, offering a methodological framework for unraveling the “black box” of environmental health relationships.
International Journal of Social Psychiatry
Mehmet Cihad Aktaş, Cemile Hurrem Ayhan, Esra Karan
It can be said that the bipolar disorder is influenced by weather events. It is stated that climate change can have direct and indirect effects on bipolar disorder. Determining the impact of the climate crisis on individuals with bipolar disorder may assist in the development of preventive, protective and active treatment interventions for this group. The study was conducted using the phenomenological method, one of the qualitative study methods. Purposive sampling was used to select the sample for the study. In-depth individual interviews were conducted with the selected sample group. Data saturation was reached with 11 participants and data collection was finalized. The study data was collected using a personal information form and an open-ended structured interview form in which participants were asked about their views and experiences of the climate crisis. Voice recordings were transcribed, and categories, sub-themes and themes were formed. People with a bipolar diagnosis are negatively affected by the impact of the climate crisis in many areas. There is a need to develop intervention programmes to arm people with a bipolar diagnosis against the negative effects of the climate crisis.
Mehmet Cihad Aktas, Cemile Hurrem Ayha
The aim of this study was to determine the addiction treatment experiences of women with substance use disorders in eastern Turkey with qualitative approach. The study was conducted using the phenomenological method, one of the qualitative study methods. Purposive sampling was used to select the sample for the study. In-depth individual interviews were conducted with the selected sample group. Data saturation was reached with 12 participants and data collection was finalized. The data was collected using a personal information form and an open-ended structured interview form in which participants were asked about their views and experiences of the climate crisis. Voice recordings were transcribed, and categories, sub-themes and themes were formed. Based on the statements of women with substance use disorders, several major themes in experiences of treatment: the path to healing, barriers and advantages. Barriers to treatment included individual barriers, institutional barriers and social barriers. Individuals’ barriers divided into several categories such as custody issue, internalized stigma, lack of knowledge, economic difficulties, lack of social security and barriers to accessing treatment.
Leena Badran, Niveen Rizkalla, Steven P Segal
Many have found that minorities seek help for mental health problems less than the general population. Such findings are surprising considering that minorities experience higher rates of mental health issues compared to the general population. Employing the Theory of Planned Behavior (TPB), this study aimed to explore the intentions of Muslims living in California and Israel pertaining seeking mental health help (SMHH). A qualitative approach involving semi-structured interviews guided by TPB principles was conducted with 78 participants. Thematic analysis was implemented to identify key themes. The findings underscored the holistic approach among Muslims toward seeking mental help incorporating medical, psychological, social, and spiritual understanding of the mental health condition. This suggests considering social and communal elements in developing interventions, education, and policy for SMHH among Muslims.
Madihah Shukri, Christopher J Armitage, Chong Siew Koon, Nurul Nabila Tarmizi
Studies have documented a heightened risk of suicidal ideation in response to stressors, especially among people from socioeconomically disadvantaged backgrounds. However, the mechanisms of this association remain elusive. Drawing on the social deterioration and counteractive models, this study aims to elucidate the pathways linking stressors to suicidal ideation through serial mediation of social support and mental health symptoms in Malaysia. Data were collected from 404 low-income adults (33.2% male and 66.8% female) receiving monthly financial assistance from Malaysia’s social welfare department. We employed stressor measures (i.e. financial, family and work), the Oslo Social Support Scale, the Patient Health Questionnaire and the Suicidal Behaviour Questionnaire-Revised. Understanding the multifaceted relationships among stressors, social support, mental health symptoms and suicide ideation expands the potential for developing targeted interventions and preventive strategies tailored for vulnerable populations. Clinical work with low-income individuals may include implementing early systematic efforts to develop accessible mental health and integrated care services.
Asylum-seeker women: Coping strategies and mental wellbeing
Sara Shishehgar, Leila Gholizadeh, Michelle DiGiacomo, Patricia Mary Davidson
Asylum seekers in Australia are subjected to various punitive measures that can affect their psychological wellbeing. The capacity of asylum seekers to adapt and cultivate effective coping strategies can enhance their resilience, facilitate their settlement processes and promote their overall mental health. This study aims to explore the coping strategies employed by women who are asylum-seekersthat have the potential to enhance their resilience post migration. A semi-structured qualitative study was conducted with asylum-seeker women from Iran. Data were analysed using an inductive thematic analysis. Seventeen participants described their experiences of applying various strategies to enhance their coping ability, resilience and maintain their mental wellbeing when facing ongoing challenges. Problem-solving strategies included social engagement, adjusting life plans and seeking support from formal and informal resources. Emotion-focussed strategies were positive thinking and maintaining hope, avoidance and spirituality. While emotion-focussed strategies enabled the women to manage their stresses temporarily, problem-solving strategies allowed them to effectively address the challenges they faced after migration.
Meng Qin Ao, Dan Luo, Hao Hou, Yu Lei Jiang, Zi Yao Lv, Bowen Li, Na Lyu, Shu Yan, Huijing Zou, Bing Xiang Yang
Non-suicidal self-injury (NSSI) among adolescents represents an alarming public health concern worldwide. Both family function and family socioeconomic status (SES) were found to play important roles in adolescent NSSI engagement. However, the effects of family function on NSSI among adolescents in different family SES are not well evidenced. This study aimed to explore how family functions (adaptation, partnership, growth, affection, and resolve) affect NSSI among adolescents in different family SES levels. Data used in this study was derived from the Students’ Mental Health Network Project (SMHN), a survey conducted among 8,872 pairs of adolescent-caregivers in a city in central China. Socio-demographic characteristics, family function, NSSI, adverse life events, and depressive symptoms were measured among adolescents. Family SES were generated from caregivers self-reported information using principal component analysis. Chi-square test and multivariate binary logistic regression analyses were adopted to analyze the effects of family function on NSSI. It revealed that 10.2% of adolescents reported engaging in NSSI in the past 12 months. Poor family function and high family SES were positively associated with NSSI. Partnership, both adaptation and affection, resolve were NSSI-protective factors for adolescents in low, middle, high family SES, respectively.
Bianca Della Rocca, Matteo Di Vincenzo, Daniela Giallanella, Costanza Gaggiano, Flavia Martinelli, Fabiana Ricci, Gaia Sampogna, Mario Luciano, Antonio Ventriglio, Antonello Bellomo, Andrea Fiorillo
Migrants face numerous risk factors for mental disorders, including stressors and traumatic events during the pre-, peri-, and post-migratory phases. Acculturation stress, a significant post-migratory stressor, can adversely affect mental health during the cultural adaptation process. This study aims to assess the clinical implications of acculturation stress in migrants admitted to a psychiatric intensive care unit, with a focus on identifying predictors of acculturative stress and their impact on clinical outcomes. We conducted a retrospective study of 268 immigrant patients hospitalized between 2004 and 2019 at the psychiatric inpatient unit of the University of Foggia. We collected socio-demographic and clinical data using ad hoc schedules and validated assessment instruments, including the Brief Psychiatric Rating Scale (BPRS), the Global Assessment of Functioning (GAF), and the Clinical Global Impression (CGI). Diagnoses were based on DSM-IV-TR/DSM-5 criteria. We analyzed associations between demographic and clinical characteristics of patients reporting acculturative stress and those not reporting it, using appropriate statistical methods. Acculturation stress is influenced by several socio-demographic factors and is crucial for the full symptomatic remission of migrant patients. Culturally-oriented mental health services, including language and cultural integration programs, are essential in reducing acculturative stress and improving the overall well-being of immigrants.
Kagiso Bojosi, Anthony A. Olashore, Hlanganiso Roy, Keneilwe Molebatsi
Schizophrenia is becoming more prevalent globally, particularly in lower and middle-income countries. Adverse childhood experiences (ACEs) are significant risk factors for developing and worsening the disorder. This study aimed to determine the pattern and correlates of ACE among inpatients with Schizophrenia at Sbrana Psychiatric Hospital in Botswana. In a cross-sectional cohort study, 128 adult patients diagnosed with Schizophrenia were sampled over a 6-month period. The Adverse Childhood Experiences International Questionnaire (ACE-IQ) and the Positive and Negative Syndrome Scale (PANSS) were used to study ACEs and assess schizophrenia severity. A regression model was used to determine factors that predicted the severity and frequency of admissions, with a significance level set at p ⩽ .05. Our findings highlight the high prevalence of multiple ACEs among patients with Schizophrenia. More interventions are therefore needed to mitigate the risk of ACEs.
Lucas Patiño-Fernández, Consuelo Vélez Álvarez, Diana Paola Betancurth Loaiza, Natalia Sánchez Palacio
Mental health is essential for overall well-being, but it is affected by disorders such as depression and anxiety, which are highly prevalent both globally and regionally. The prevalence of these disorders has risen due to factors such as the SARS-CoV-2 pandemic, lack of adequate investment in mental health care, and the implementation of low-impact strategies. To establish the social determinants of health associated with the self-perception of sadness, depression, and/or anxiety in people in Colombia. Using the DESOSA81 tool, a quantitative, cross-sectional study with a correlational phase was conducted with 2,725 participants from the five regions of the Colombian mainland. Data were collected through a digital survey and analyzed using Jamovi software to perform univariate, bivariate, and multivariate analyses (logistic regression). Heterogeneity was found in the predictive determinants between regions. The Amazon presented the regression model with the highest prediction (R2N = 0.650), while Orinoco had the lowest (R2N = 0.503). Among the social determinants associated with a greater risk of sadness, depression, and anxiety, those found to have a significant influence on emotional self-perception are female gender, stress, support networks, and social cohesion. Stress management and interpersonal relationship programs, comprehensive family care strategies, and community support should be strengthened. Furthermore, public policies should adopt comprehensive approaches that go beyond the biomedical paradigm.
Journal of the Royal Anthropological Institute
Aaron J. Jackson
This article demonstrates the important role family narratives can play in providing ethical, person-centred support for people with severe intellectual disabilities living in supported accommodation. Focusing on the story of Daniel, a 65-year-old man residing in a group home in Australia, I illustrate, through the lens of his mother Arleen, how family narratives foreground those with intellectual disabilities as holders and makers of memories, offering valuable social and narrative contexts for their ethical treatment. I conceptualize family narratives as evolving frameworks that give meaning to the lives of people, both individually and as a group, grounding shared and individual ways of being and understanding through the passage of time. In a time where the disability sector increasingly emphasizes personal autonomy and choice for service users, I argue for an embodied understanding of ethics, of paying the other their due, by attending to the stories that constitute people as relational beings. This is particularly relevant in the context of consumer-oriented support, which can drive individualizing, one-size-fits-all approaches to a person’s ethical treatment. Such narratives have the potential to influence professional practice and promote a more connected approach to person-centred support that recognizes the embodied and relational dimensions of our lives.
Migration and mental health care in South Africa: the question of language in context
Christine Anthonissen, Rowan Madzamba, Asithandile Nozewu, Warona Mateane, Leslie Swartz, Sanna Higgen, Brian Hall, Mike Moesko
Access to mental healthcare for migrants is a global problem, with many challenges and barriers, including the issue of language discordance. Most research on this topic comes from well-resourced countries such as those in Europe, Northern America, and Australasia despite the fact that most migration occurs from poorer contexts, such as many in Africa, into more closely situated countries. As an introductory part of a broader international study, we started out investigating the views of key stakeholders in South Africa on language barriers to accessing mental healthcare for migrants and suggestions for how to address these. Two senior researchers interviewed a total of 10 key stakeholders (mental health and primary healthcare providers, some also users of mental healthcare, policymakers in mental healthcare, and refugee centre coordinators) virtually, using semistructured interviews. Interview recordings were transcribed and the content was analysed. The following key themes emerged from our data: general barriers to mental healthcare; linguistic barriers to mental healthcare; proposed solutions to overcoming language discordance and alternatives suggested by professionals and mental health service users. Issues of language were intertwined with a range of other service delivery and political problems. The issue of lack of language concordance is a major concern in providing mental healthcare for migrants in South Africa. This is, however, by no means the only concern, as access to care in general is poor. Innovative, cost-effective local solutions are needed to bridge the enormous gap between needs and service provision.
Fay Bound Alberti, Dallas Weins, Annalyn Bell Weins
A recent review of face transplants argues that overall, they have been successful. But this verdict is based on surgical measures rather than patient-reported outcomes (PROMs), which for historical reasons are in their infancy. These measures are critical to understanding the nature of success in face transplants, and the evidence from mixed systems of healthcare, as in the USA, reveals that there are significant ethical and social concerns about the well-being of patients. Medical humanities research that focuses on the lived experience of patients and their caregivers can contribute significantly to the discussion by focusing on patient voices and the measures that matter outside of surgical contexts. This article builds on existing work and original interviews with face transplant recipients and their families from an emotion history perspective. It argues that surgical measures used in isolation can be misleading. We need a more holistic understanding of outcomes—financial, psychological and emotional as well as medical—that requires the insights drawn from the humanities and transforms the definition and measurement of ‘success’.
Mpox in the news: social representations, identity, stigma and coping
Brigitte Nerlich, Rusi Jaspal
In May 2022, when the COVID-19 pandemic began to recede from public view, another infectious disease surprised the world—mpox (formerly monkeypox). It appeared to disproportionately affect gay, bisexual and other men who have sex with men (GBMSM). Using qualitative thematic analysis and social representations theory, we analysed a corpus of 91 items from a variety of news outlets that included GBMSM community members’ personal accounts of living through an mpox outbreak. The aim was to study the various ways in which members of a marginalised group created social representations of mpox and to ascertain whether these challenged older representations related to HIV and AIDS and newer ones related to COVID-19. Commentators anchored mpox to known, culturally accessible phenomena to render this previously unfamiliar disease familiar; objectified aspects of mpox, especially pain, through emotive language, making it ‘real’ and psychologically tangible; personified it by linking it to accounts of celebrity activists; and ontologised it through visually vivid descriptions. Challenging stigma was a cross-cutting theme in people’s accounts. In contrast to the stigmatising imagery of health issues affecting GBMSM, these accounts contribute to the development of social representations designed to challenge such stigmatisation, which, in the contexts of HIV and AIDS and COVID-19, has hindered effective medical interventions, promoted misinformation and fuelled denigration.
‘Finally making sense’: graphic medicine and ADHD diagnosis in adulthood
Sathyaraj Venkatesan, Prerna Tolani
This article aims to examine the lived experiences of attention-deficit/hyperactivity disorder (ADHD) diagnosis in adulthood, emphasising its revelatory nature and diverse emotional responses it provokes. The diagnosis serves as a pivotal moment of self-discovery, often evoking feelings of validation and identity affirmation. However, it also triggers a complex array of emotions, including grieving for the childhood self, frustration with society’s failure to recognise the legitimate challenges and evolving self-concept post diagnosis. Through a close reading of digitally published comics by Laura Balcerek, Amber Lewis and Juliette Yu-Ming Lizeray, this article studies how the graphic medium conveys these nuanced experiences. By dissecting narrative and visual elements inherent in the comics, the article studies the affordances of the comic medium to capture the lived experiences of ADHD diagnosis in adulthood. Ultimately, this article intends to deepen understanding of the diverse lived realities and underscores the expressive potential of graphic narratives of neurodivergence.
Science, Technology, & Human Values
The (Anti)Microbial Gaze: Surveillance Meets Resistance
Katherine Kenny, Alex Broom, Leah Williams Veazey, Jennifer Broom
Antimicrobial resistance (AMR) is a rapidly escalating global health threat, known increasingly through different forms of monitoring. Surveillance, both of resistant organisms and of the antimicrobial prescribing practices that contribute to their proliferation, has increased dramatically over the last decade. So too have audits, which are routinely deployed to evaluate, and ensure accountability for, the alignment of local prescribing practices with established “best practice” guidelines. However, governing AMR in this way raises important questions including: how do these forms of monitoring play out in practice, and with what consequences? How do they articulate with the machinations and temporalities of hospital governance more generally? Here, drawing on in-depth interviews with thirty-six participants ranging from ward nurses to hospital executives in metropolitan Australia, we ask what, precisely, this particular way of monitoring medics and microbes—which we conceptualize here as the (anti)microbial gaze—makes visible in the hospital setting, what might be obscured, and how this particular way of knowing may delimit what is seen as possible in terms of intervening in the growing challenge of antimicrobial resistance.
Jaunathan Bilodeau, Nancy Beauregard, Victor Y. Haines III, Amélie Quesnel-Vallée
Women face a higher risk of common mental health disorders than men, an association that has largely been attributed to their greater exposure to stressors. However, studies testing the exposure hypothesis among the employed population rarely take into account the work-family interface and neglect the macro-social context in the construction of gender.
This study examines a gendered exposure model, stratified by Canadian province, in which differences between working women and men in work and family conditions, work-family conflict, and work-family enrichment are linked to self-reported mental health inequalities. Path analyses were conducted for Alberta, British Columbia, Quebec, and Ontario using data from 6,786 employed respondents to the 2022 Canadian Community Health Survey. The exposure hypothesis was tested through indirect associations between sex categories and mental health via work and family conditions and the work-family interface.
Findings show that in Quebec, women report higher work stress, which is indirectly linked to poorer mental health through increased work-to-family conflict. In Alberta, women report more work stress, which is associated with poorer mental health. Women also work fewer hours than men, a factor linked to poorer mental health in Quebec and Ontario.
Overall, the results indicate that work-family stressors and resources contribute more to provincial differences in mental health than in gendered mental health inequalities, highlighting the need to differentiate between general determinants of mental health and the factors driving mental health disparities. This study emphasizes the importance of integrating the work-family interface when documenting the structuring influence of gender on mental health inequalities.
Fawn Harrad-Hyde, Chris Williams, Natalie Armstrong
Older people living in care homes are susceptible to deteriorations in their health. At times of deterioration, care home staff play a crucial role in considering the potential benefits and burdens associated with either caring for the resident in the home or transferring them to hospital. Using data collected through interviews with 30 care home staff and 113 h of ethnographic fieldwork in care homes in England, we consider the ways that care home staff can perceive deteriorating care home residents to be, often simultaneously, vulnerable (or ‘at risk’) and dangerous (or ‘a risk’) in both the hospital and the care home. Drawing on the work of Mary Douglas, we suggest deteriorating care home residents can be considered to be ‘matter out of place’ and can therefore be considered as ‘placeless’ in whichever setting they receive care. Instead of asking whether deteriorating residents are in the ‘right place’ to receive care, we might instead ask whether healthcare services are the ‘right shape’ to support to deteriorating care home residents and their complex needs.
Yi-Han Chang, Shu-Sen Chang, Jui-fen Rachel Lu, Tung-liang Chiang
Previous studies on maternal postpartum mental health are limited by non-representative samples, a narrow focus on mental illness, and a lack of systematic examination of predictors for diverse mental health trajectories. We investigated maternal mental health trajectories during eight years postpartum and their socio-demographic, family, and health-related predictors in a large cohort of mothers in Taiwan. Participants were 17,886 mothers drawn from the Taiwan Birth Cohort Study (TBCS), a cohort study of a nationally representative sample of children born in Taiwan in 2005 and their parents. Maternal mental health was assessed at 6, 18, 36, 66, and 96 months postpartum using the Mental Component Summary (MCS) from the 36-item Short-Form Health Survey (SF-36) Taiwan version. We used group-based trajectory modeling to identify trajectory groups of maternal mental health and examined their predictors using multinomial logistic regression. Our findings highlight distinct maternal mental health trajectories over eight years postpartum, with one in five mothers experiencing deteriorating or persistently poor mental health. Socio-demographic factors, family function, and early postpartum health were predictors of these trajectories.
Zuxing Wang, Yu Ye, Yikai Dou, Lili Chen, Zhili Zou
Self-harm and interpersonal violence are pressing global public health concerns, with high alcohol consumption being a significant contributing factor. This study analyzes global trends of self-harm and interpersonal violence attributable to high alcohol use from 1990 to 2021, including the impact of the COVID-19 pandemic. Age-standardized death rates (ASDR) and disability-adjusted life years (DALYs) were extracted from the Global Burden of Disease (GBD) 2021 to explore the trends of burden. Data were categorized by gender, age groups, regions, and countries, each with a 95 % uncertainty interval (UI). Bayesian age-period-cohort (BAPC) models were used to forecast future trends. Global alcohol-related self-harm and violence declined long-term but stalled during COVID-19, with higher burdens among males and specific age groups, and significant regional disparities. Sustained public health efforts, targeted policies, and innovative interventions are essential to address persistent disparities and future challenges.
Midlife Women’s Misaligned Educational Expectations and Serious Mental Illness
Kelsey Shaulis
Women were the driving force behind the expansion of higher education in the United States. Their rise in enrollment developed alongside a rapid increase in educational expectations. This study explores the question of how these landmark shifts in women’s expanded expectations, attainment, and the (mis)alignment of the two have influenced mental health now that these women have entered midlife. Using data from the sophomore cohort of the 1980 High School and Beyond (HS&B:So) study through its 2014 midlife follow-up, results show that for women in the sophomore cohort (n = 2,010), exceeding educational expectations is significantly associated with an increase in experiencing serious mental illness in midlife compared to meeting or missing educational expectations. These results suggest that overachieving educational expectations carry distinct psychological consequences.
Jin A Lee, Markus H. Schafer
Drawing from the life-course framework and an integrated model of social resources and social costs, this article investigates (1) the dynamics of personal network changes, (2) their impact on loneliness following widowhood, and (3) the gender-specific effects of these changes. Analyzing panel data from the German Ageing Survey (N = 7,012; observations = 20,816) using multi-level mixed-effects models, the study reveals a modest expansion in non-kin networks and the number of children in networks after widowhood. Additionally, the findings indicate that over time, widowed individuals generally experience a reduction in the distance to their nearest network members, particularly kin. Growing non-kin networks are associated with lower loneliness following widowhood. Geographic changes in networks display gender-specific patterns: proximity to children is linked to reduced loneliness for widowed men, but greater loneliness for widowed women. These results underscore the complex and gendered nature of relational adaptations to widowhood, highlighting that network changes can offer both benefits and challenges during life transitions. The study also suggests that considering opportunity costs can be a valuable extension of the social cost framework.
The Sociology of Mental Health and the Twenty-First-Century Mental Health Crisis
Jason Schnittker
In this article, I address the current mental health crisis in the United States, consisting of a rapid rise in anxiety and depression among millennials and growing deaths of despair among non-college middle-aged adults. I argue that the twin crises have much in common, as different as they might appear. Both are crises of subjective interpretation and meaning as much as objective circumstance and opportunity. Yet to date they have been interpreted narrowly, as reflecting environmental and technological change and growing impingements on the individual, whether with respect to a rise in social media or a decline in manufacturing jobs. In research on rising mortality, despair has slowly assumed secondary status to deaths. Here, I argue that there is more to the overall mental health crisis, and for this reason, the crisis is worse than it appears. Generations are exposed to more stressful environments, but the cultural environment has also failed to provide them with the tools to cope and manage the consequences of their suffering. Furthermore, even as social conditions have conspired to increase emotional suffering, the social environment has demanded even greater mental fitness, creating an increasingly mental health-biased socioeconomic environment. A sociological approach to the crisis would incorporate a more expansive view of the person and the situation, allowing for more consideration of meaning-making, adaptation, self-conception, and how mental health problems are received. Among other things, this would recenter mental health among the tangle of problems adumbrated in the literature on rising anxiety and mortality.
Rachel Donnelly, Whitney Frierson, Zhe Zhang, Courtney E. Boen
Financial hardship was pervasive during the COVID-19 pandemic, with adverse consequences for mental health. However, access to state-level paid sick leave during the pandemic had the potential to reduce the mental health burden of financial hardship—a possibility that has not been tested in prior research. Using nationally representative survey data on more than 1.7 million individuals from the Household Pulse Survey (August 2020 to November 2022) merged with state-level data on paid sick leave policies, we estimated a battery of two-way fixed-effects linear probability models to examine whether paid leave policies buffered the association between financial hardship and depression and anxiety risks. Results show that experiencing financial hardship increased depression and anxiety risks but that the mental health consequences of financial hardship were dampened for respondents living in a state with an active paid sick leave policy. Moreover, because racially minoritized adults, women, transgender adults, and less-educated adults were more likely to experience financial hardship over the period, our study highlights the potential for paid leave policies to reduce population inequities in mental health. We point to paid sick leave policies as an important macro-level determinant of mental health with especially salient mental health consequences for marginalized groups.
Cultural variations in psychosis: Recent research and clinical implications
G. Eric Jarvis
This article introduces a thematic issue of Transcultural Psychiatry dedicated to understanding the role of culture in the expression and treatment of psychotic symptoms. While many clinicians and researchers view psychotic disorders as brain diseases firmly rooted in neurological processes and requiring medical treatments to resolve, the papers in this issue propose something different: that psychotic symptoms are refracted through the lens of culture with the result being socially and culturally constructed disorders that have as much to do with the attitudes and knowledge systems of the observer as the lived experience of patients. Hence, expression of psychotic symptoms and disorders represent the result of a negotiated space between individual distress and the values and norms of the wider society. This thematic issue touches on several important points: critical perspectives of high rates of psychosis in migrants, the lack of culturally adapted research and clinical tools in psychosis work, new methods to engage people with psychosis from diverse backgrounds, and cultural issues related to the etiology of psychosis, interpretation of symptoms, and help–seeking. There remain many important topics at the intersection of culture and psychosis not covered by this thematic issue, including stigma and psychosis, delusion formation in cultural context, the history of psychosis concepts, and insight in psychosis. Yet, despite these omissions, the articles in this issue, as a whole, foster recognition of the limits of standard approaches to psychosis and advocate for culturally adapted assessments and interventions, which if implemented from a position of cultural humility, carry the long–term potential of revolutionizing the field.
Cultural interplay shaping the well-being of Ghanaian migrants in Japan during the COVID-19 pandemic
Floret Maame Owusu, Nobutoshi Nawa, Yu Par Khin, Takeo Fujiwara
Ghanaian migrants in Japan, who make up the second-largest population of African migrants in the country, may have faced heightened racial prejudice and challenges during the COVID-19 pandemic, impacting their well-being. This study explored cultural factors shaping the well-being of Ghanaians living in Japan during the COVID-19 pandemic through a qualitative study using the socioecological model. From June 2022 to August 2022, 18 in-depth interviews and 2 focus group discussions were conducted among Ghanaian migrants in Japan. Interviews were audio recorded and transcribed, and an inductive thematic approach was used to analyze the data. At the individual level, the internalized face mask culture, financial constraints, reluctance to access mental healthcare services, and hesitancy toward COVID-19 vaccine played major roles in the well-being of Ghanaian migrants. Adherence to social distancing and coping using religious and social circles influenced their well-being at the interpersonal level. At the community and societal levels, important influences on well-being were language barriers, discrimination and COVID-19-related stigma, and trust in Japan’s healthcare system. In conclusion, while Ghanaian migrants in Japan faced challenges during the pandemic, affecting them physically and psychologically, they were able to cope through the religious and social ties from Ghana that they maintained.
Ahisha Jones-Lavallée, Yvan Leanza
The use of the Cultural Formulation Interview (CFI), a semi-structured 16-item cultural assessment developed for the DSM-5, has not yet been evaluated in the context of post-secondary education campuses (Cégeps and universities). The aim of this study was to assess whether a 2-h training session on the CFI improved cultural competence in clinicians working in student counseling centers throughout the province of Québec as well as to evaluate the clinicians’ attitudes toward the adoption of the CFI and their perceptions of the tool’s feasibility, acceptability, and clinical utility. Thirty-nine clinicians from seven Cégeps and universities completed the pre-training questionnaires, participated in the 2-h training session, and then completed the post-training questionnaires. Paired-samples t tests were used to compare change in the scores of self-reported cultural competence pre and post training. Clinicians favorably rated the assessment tool, and most clinicians (89%) reported that they planned to incorporate the CFI into their routine clinical practice. There was an increase in multicultural counseling knowledge post training session, as well as a decrease in the multicultural counseling relationship subscale. Potential barriers to the use of CFI were also identified. More research is needed to explore the use of the CFI in different clinical contexts, as well as to evaluate the impact of cultural competence training on clinical practice.
Decolonizing psychiatry: An example from Hinduism and psychoanalysis
Neil Krishan Aggarwal
In 2021, university scholars hosted a conference titled “Dismantling Global Hindutva,” which prompted Hindu activists to criticize psychoanalysts for superimposing colonial frameworks onto Hindus. Indian media organizations have questioned the validity of psychoanalysis as scholars uncover the complicity of psychoanalysts with the British Empire. Drawing upon concepts in cultural psychiatry, this article operationalizes ontological perspectivism as a way to decolonize the application of psychological theories among historically-marginalized communities. It presents three perspectives on psychological phenomena. It begins with analyzing the first psychoanalytic study on Hindu scriptures by the psychoanalyst–British colonial administrator Owen Berkeley-Hill through his autobiography, writings from contemporaries, the study itself, and subsequent citations. This study served as model for future work in psychoanalysis that portrayed Hindus in ways that Hindu activists now criticize. Next, the essay presents translations of Sanskrit commentaries on the same scriptures from Hindu philosophers to see how observant Hindus have received their tradition. Finally, it examines writings from contemporary psychoanalysts and psychiatrists who have tried reconciling mental health theories and Hinduism. Ontological perspectivism offers an approach for intercultural dialogues among scholars in distinct intellectual traditions to develop a postcolonial psychiatry.
