ISSN:0033-3174    

出版商:OVID    

年代:1998

数据来源: OVID

ISSN:0033-3174    

出版商:OVID    

年代:1998

数据来源: OVID

摘要:

ObjectiveThis study examines social processes that construct the course of chronic illness. Specifically, it identifies and describes mechanisms that constitute the process of role constriction in employment for individuals with chronic illness.MethodSixty-six persons meeting the Centers for Disease Control case definition of chronic fatigue syndrome (CFS) participated in a longitudinal study involving three waves of data collection over 3 years. Qualitative and quantitative methods were combined in the research, which included face-to-face semistructured interviews, telephone interviews, and self-report questionnaires. Materials presented in this study are drawn principally from the Year 1 face-to-face and telephone interviews.ResultsWhen patterns of symptoms and of the illness course in CFS intersect with work requirements, they impede performance and place ill individuals at risk for job loss. Persons with CFS devise and implement specific strategies to resist role constriction and remain in the work force.ConclusionsRole constriction is a social process of marginalization in chronic illness. Opposing forces of marginalization and resistance define the social course in chronic illness and suggest that chronicity can be thought of as a marginalized position in social space.

ISSN:0033-3174    

出版商:OVID    

年代:1998

数据来源: OVID

摘要:

ObjectiveAIDS Neurosis is an illness phenomenon in which the person suffering is convinced that he or she is HIV positive, despite negative test results, and a range of nonspecific physical symptoms and phobic and neurotic tendencies, are manifested. To explore the relationship between culture and mental illness, this study examines a) the emergence of AIDS Neurosis as a socially recognized clinical entity in contemporary Japan, and b) the claims by activists, psychiatrists, health officials, and others that AIDS Neurosis is a culturally unique illness phenomenon specific to Japan.MethodsThe data was collected during 12 months of ethnographic fieldwork in Japan, supplemented by readings in popular and clinical literature.ResultsThe cultural explanations proferred for AIDS Neurosis clearly inform the meanings and practices surrounding this phenomenon, but such cultural stereotypes are too simplistic and are not sufficient for understanding the development of AIDS Neurosis nor the complex attitudes and practices relating to AIDS in Japan.ConclusionsThis study argues for a more critical perspective on culture, which attends to the local contests and practices involved in making an illness category such as AIDS Neurosis.

ISSN:0033-3174    

出版商:OVID    

年代:1998

数据来源: OVID

摘要:

ObjectivesIn North America and Europe, it is usually assumed that biological changes associated with the end of menstruation and the onset of specific diseases commonly associated with the postmenopausal condition are universal. Using an anthropological approach in which menopause is understood as a concept that is historically and culturally produced, an argument is made for additional systematic investigation of what protects the majority of women from distress at menopause, and what factors contribute to a healthy old age.MethodSurvey research based on questionnaire responses, together with open-ended interviews and textual analyses, were used.ResultsDifferences are demonstrated in postmenopausal experiences and symptom reporting in Japan as compared with Canada and the United States. Reporting of hot flashes and nights sweats is significantly lower in Japan. These findings, together with the well established figures about greater longevity and lower incidence of heart disease, breast cancer, and osteoporosis in Japan, compared with North America, indicate that cultural and biological variables act in concert to produce this variation. Theories about the evolution of menopause and demographic data on aging are also discussed. This data challenges the widely held assumption that populations of postmenopausal women only recently have come into existence because of cultural and technological interventions.ConclusionsPostmenopausal women have been present in human populations since homo sapiens first evolved. Culturally mediated life styles affect both the menopausal experience and the health of women as they age. Additional investigations are needed.

ISSN:0033-3174    

出版商:OVID    

年代:1998

数据来源: OVID

摘要:

ObjectivesThe cross-cultural prevalence of somatization and the limitations of current nosology and psychiatric theory for interpreting cultural variations in somatization are reviewed.MethodSelective review was conducted of recent research literature and research findings from an epidemiological survey and ethnographic study of help-seeking and health care utilization of a random sample of 2246 residents in a Canadian urban multicultural milieu.ResultsSomatization is common in all ethnocultural groups and societies studied to date. However, significant differences in somatization across ethnocultural groups persist even where there is relatively equitable access to health care services. Analysis of illness narratives collected from diverse ethnocultural groups suggests that somatic symptoms are located in multiple systems of meaning that serve diverse psychological and social functions. Depending on circumstances, these symptoms can be seen as an index of disease or disorder, an indication of psychopathology, a symbolic condensation of intrapsychic conflict, a culturally coded expression of distress, a medium for expressing social discontent, and a mechanism through which patients attempt to reposition themselves within their local worlds.ConclusionMajor sources of differences in somatization among ethnocultural groups include styles of expressing distress ("idioms of distress"), the ethnomedical belief systems in which these styles are rooted, and each group's relative familiarity with the health care system and pathways to care. Psychological theories of somatization focused on individual characteristics must be expanded to recognize the fundamental social meanings of bodily distress.

ISSN:0033-3174    

出版商:OVID    

年代:1998

数据来源: OVID

ISSN:0033-3174    

出版商:OVID    

年代:1998

数据来源: OVID

摘要:

ObjectiveThe purpose of this study is to explore the apparent social mediation of a postpartum somatic illness, na tadoka ni vasucu, occurring among ethnic Fijian women.MethodDuring their first two postpartum days, 85 consecutive newly delivered ethnic Fijian women were recruited for a prospective study on na tadoka ni vasucu at the Sigatoka District Hospital in Nadroga, Fiji. Subjects underwent translated structured interviews and responded to the Kellner Symptom questionnaire and to visual analog scales to assess social supports and occurrence of mood symptoms or an episode of na tadoka ni vasucu in the postpartum period. Semistructured ethnographic interviews were also conducted with subjects who reported an episode of na tadoka ni vasucu. Data were collected in the initial postpartum days and again at 2 to 5 months postpartum; 82 women completed the study.ResultsNa tadoka ni vasucu is a somatic syndrome occurring in 9% (N = 7) of this sample. Both quantitative and narrative data demonstrate that this syndrome is associated with perceived inferior social supports. Despite its relatively infrequent occurrence and benign clinical course, the disorder is a subject of serious social concern within the Fijian community.ConclusionsAlthough na tadoka ni vasucu seems to be clinically trivial, because of its cultural salience it is nonetheless able to mobilize intensive social surveillance and care for the postpartum mother. The moral concern generated by this culturally marked disorder, as well as its association with perceived inferior social supports, suggest a dialectical relationship between somatic idiom and its social context.

ISSN:0033-3174    

出版商:OVID    

年代:1998

数据来源: OVID

摘要:

ObjectiveThis study sets forth the premises of psychosomatic and sociosomatic approaches in medicine and psychiatry and considers how these approaches differentiate or complement one another. The course of persistent mental illness is examined in sociosomatic terms by considering a life defined by a cycle of expectation, violation, illness, and recovery.MethodA case study of a Puerto Rican woman is drawn from a larger study of the course of depression and schizophrenia among 80 Latinos and Euro-Americans.ResultsAnalysis of the patient's narrative reveals a set of interrelated themes in terms of which this cycle is structured.ConclusionThe study concludes by offering a structural model of the sociosomatic reticulum that define the interaction between bodily experience and social relationships or conditions.

ISSN:0033-3174    

出版商:OVID    

年代:1998

数据来源: OVID

摘要:

ObjectiveTo study the sociocultural transformation of neurasthenia (shenjing shuairuo, SJSR), as both disease and illness, in Chinese society.MethodThis is based on a critical review of evidence drawn from the psychiatric and anthropological literature, and the use of a single case study.ResultsSJSR remains a ubiquitous illness in socio-politically different Chinese societies, but the Americanization of Chinese psychiatry has paradoxically made the "same" disease category languish rapidly in professional practice. Although it engages bodily modes of attention, SJSR is far from being a physical, somatoform, or chronic fatigue disorder.ConclusionsPsychiatric disease and illness do not run a "natural" course independent of social and historical contexts. SJSR usefully muddles the Cartesian mind-body dichotomy and is readily compatible with psychosocial manifestations and explanatory models. From a sociosomatic perspective, the embodied world of SJSR may arbitrate as well as critique the conjunctures of large-scale political, economic, and moral transformations in Chinese communities. These macrosocial forces and their local manifestations need to be considered in deriving a cross-culturally valid paradigm of psychosomatic medicine.

ISSN:0033-3174    

出版商:OVID    

年代:1998

数据来源: OVID