<Emphasis Type="Italic">Susto</Emphasis> and<Emphasis Type="Italic"> Nervios</Emphasis>: Expressions for Stress and Depression

Folk illnesses that are cultural constructions of psychological distress offer a vehicle for the cross-cultural study of stress and stress-related morbidity. This study explores the relationship between the Latin American folk illnesses susto and nervios and mental health. We hypothesize that these folk illnesses are distinct and that there is a stronger association between current levels of stress and depressive symptoms with past experience of nervios than with susto, because the cultural constructions of these folk illnesses reflect chronic and acute concepts of distress, respectively. Interviews were conducted in Guadalajara, Mexico, where participants responded to questions about their socio-demographic characteristics, stress, depressive symptoms, and whether they had experienced susto or nervios. Susto and nervios are very prevalent and occur across sociodemographic subgroups, with the exception that nervios occurred more often in women (p < 0.05). Susto was significantly associated with stress and depressive symptoms (p < 0.05), but nervios had a much stronger association (p < 0.0001), even after controlling for gender. Susto and nervios were expressions of psychological distress; most of those with depression reported susto and/or nervios. This study validates the link between these folk illnesses and stress and depression and may, ultimately, facilitate cross-cultural research on stress.     

The Psychotropic Self/Imaginary: Subjectivity and Psychopharmaceutical Use Among Heroin Users with Co-Occurring Mental Illness

Many people diagnosed with mental illnesses struggle with illicit drug addiction. These individuals are often treated with psychiatric medications, yet little is known about how they experience this treatment. Research on the subjective experience of psychiatric medication use highlights the complex, contradictory, and ambiguous feelings often associated with this treatment. However, for those with mental illness and addiction, this experience is complicated by the need to manage both psychiatric medication and illicit drug use. Using ethnographic data from a study of heroin use in Northeast Ohio, we explore this experience by expanding the pharmaceutical self/imaginary (Jenkins, Pharmaceutical Self: The Global Shaping of Experience in an Age of Psychopharmacology, School for Advanced Research Press, Santa Fe, NM, 2010b) to include psychopharmaceuticals and illicit drugs, what we call the psychotropic self/imaginary. Through this lens we explore the ways participants interpret and manage their psychotropic drug use in relation to sociocultural, institutional, and political–economic contexts. This analysis reveals how participants seek desired effects of legally prescribed and illicit drugs to treat mental illness, manage heroin addiction, and maintain a perceived “normal” self. Participants manage their drug use using active strategies, such as selective use of psychiatric medications, in the context of structural constraints, such as restricted access to mental health care, and cultural contexts that blur distinctions between “good” medicines and “bad” drugs.     

Part of my story. The meaning and experiences of genes and genetics for sperm donor-conceived offspring

Existing empirical research often do not explain which concepts about genetics underlie the assumption that genetic information is deemed important for donor-conceived offspring. This study focused on how donor-conceived individuals following anonymous sperm donation give meaning to and make sense of genes and genetics. Analysis is based on focus groups and interviews with adult donor-conceived offspring. Findings suggest that genes are part of their specific context of being donor-conceived but also play a role in daily life. Genes make sense on an individual level and a relational level, both on parent-child as sibling-level. On an individual level they were perceived as (1) a biological starting package, (2) their own unique combination and (3) as a reference point. On a relational level, genes were seen as (1) “person-al”, (2) connecting and (3) locating individuals. This information is essential for those supporting/counseling donor conceived offspring and families as well as for policy-members.     

Twice-Born, Once Conceived: Meaning Construction and Cultural Cognition

Cultural cognition is the product of two different sorts of meaning: (a) the (objective) semiotic organization of cultural texts or models, and (b) the (subjective) processes of meaning construction through which cultural symbols become available to consciousness as "experience." This article proposes a way to bridge these two kinds of meaning by considering how cultural knowledge is grounded in sensory experience. Several cognitive processes (schematization, synesthesia, secondary intersubjectivity) are proposed for linking the objectively available schemata found in cultural practices and the processes of meaning construction by which individuals appropriate symbols to consciousness. The nature of the relation between public symbols and individual experience is discussed in relation to a number of current issues in post-structuralist culture theory.     

Effects of early experience on the behaviour of yearling rhesus monkeys (Macaca mulatta) in the presence of a strange object: classification and correlation approaches

Special techniques are needed to help us understand the long-term effects of infants' experiences of their relationships with their mothers, especially when direct experimental control of the interaction between mother and young is impossible, or could distort their relationship. A classification approach is developed to show how outcomes in individuals can be predicted from their earlier experiences and characteristics. Four-week-old rhesus monkey infants' characteristic levels of enterprise persisted through their first year, but could be reduced in certain individuals who had been kept off their mothers by high rates of early maternal rejection. Correlational approaches are difficult to interpret when they fail to confirm simple effects of experience or of individual characteristics, because they are based on groups not individuals, and because certain individuals can affect the values of correlation coefficients in ways that cannot be specified without using a classification approach. The possible effects on correlation coefficients of inconsistent individuals, and of being unable to specify which infants respond in which ways to relevant variables were discussed.     

Finding meaning in first episode psychosis: experience, agency, and the cultural repertoire

The article examines individuals' attempts to generate meaning following their experiences with psychosis. The inquiry is based on a person-centered ethnographic study of a Danish mental health community program for early intervention in schizophrenia and involves longitudinal interviews with 15 of its participants. The article takes an existential anthropological perspective emphasizing agency and cultural phenomenology to investigate how individuals draw on resources from the cultural repertoire to make sense of personally disturbing experiences during their psychosis. It is suggested that the concept of "system of explanation" has advantages over, for example, "illness narrative" and "explanatory model" when demonstrating how some individuals engage in the creative analytic and theory-building work of bricolage, selecting, adding, and combining various systems of explanation. Delusions are equally derived from the cultural repertoire but are constructed as dogmatic explanations that are idiosyncratic to the individual who holds them.     

Family solidarity and informal care: the case of care for people with dementia

According to Bayertz the core meaning of solidarity is the perception of mutual obligations between the members of a community. This definition leaves open the various ways solidarity is perceived by individuals in different communities and how it manifests itself in a particular community. This paper explores solidarity as manifested in the context of families in respect of caregiving for a family member who has become dependent because of disease or illness. Though family caregiving is based on the same perception of mutual obligation as the solidarity that supports welfare arrangements in society, the manifestation of solidarity in families is different. Solidarity that underpins welfare arrangements is based on a perception of mutual obligation towards an anonymous dependent other and is enforced by the government. Solidarity in families is directed towards a concrete other and is based on free choice, albeit often accompanied by a strong sense of personal duty. In this paper we try to distinguish between solidarity as a sociological concept and as a moral concept. An important moral element of solidarity, as expressed in families, is the need for recognition of family caregivers, not only of their concrete practical efforts, but also of their own identity as caregivers and as individuals. We illustrate this argument by referring to examples in the Nuffield Council on Bioethics report Dementia: ethical issues, about the experiences of family caregivers in dementia care and the importance for them of recognition of their role.     

A new approach to the diagnosis of deficits in processing faces: Potential application in autism research

Deficits in social communication are one of the behavioral signatures of autism spectrum disorder(ASD). Because faces are arguably the most important social stimuli that we encounter in everyday life, investigating the ability of individuals with ASD to process faces is thought to be important for understanding the nature of ASD. However, although a considerable body of evidence suggests that ASD individuals show specific impairments in face processing, a significant number of studies argue otherwise. Through a literature review, we found that this controversy is largely attributable to the different face tests used across different studies. Therefore, a more reliable and valid face test is needed. To this end, we performed a meta-analysis on data gleaned from a variety of face tests conducted on individuals with developmental prosopagnosia(DP) who suffer a selective deficit in face processing. Based on this meta-analysis, we selected an old/new face recognition test that relies on face memory as a standard diagnostic test for measuring specific face processing deficits. This test not only reliably reflects DP individuals' subjective experiences with faces in their daily lives, but also effectively differentiates deficits in face processing from deficits caused by other general problems. In addition, DP individuals' performance in this test predicts their performance in a variety of face tests that examine specific components of face processing(e.g., holistic processing of faces). Finally, this test can be easily administrated and is not overly sensitive to prior knowledge. In summary, this test can be used to evaluate face-processing ability, and it helped to resolve the controversy whether individuals with ASD exhibit face-processing deficits.     

The relationship between the golden spiny mouse circadian system and its diurnal activity: an experimental field enclosures and laboratory study

Examples of animals that switch activity times between nocturnality and diurnality in nature are relatively infrequent. Furthermore, the mechanism for switching activity time is not clear: does a complete inversion of the circadian system occur in conjunction with activity pattern? Are there switching centers downstream from the internal clock that interpret the clock differently? Or does the switch reflect a masking effect? Answering these key questions may shed light on the mechanisms regulating activity patterns and their evolution. The golden spiny mouse (Acomys russatus) can switch between nocturnal and diurnal activity. This study investigated the relationship between its internal circadian clock and its diurnal activity pattern observed in the field. The goal is to understand the mechanisms underlying species rhythm shifts in order to gain insight into the evolution of activity patterns. All golden spiny mice had opposite activity patterns in the field than those under controlled continuous dark conditions in the laboratory. Activity and body temperature patterns in the field were diurnal, while in the laboratory all individuals immediately showed a free-running rhythm starting with a nocturnal pattern. No phase transients were found toward the preferred nocturnal activity pattern, as would be expected in the case of true entrainment. Moreover, the fact that the free-running activity patterns began from the individuals' subjective night suggests that golden spiny mice are nocturnal and that their diurnality in their natural habitat in the field results from a change that is downstream to the internal clock or reflects a masking effect.     

Restructuring Illness Meaning Through the Clinical Encounter: A Process of Disruption and Coherence

This study explores restructuring of illness meaning among ten Turkish-born women, assessed as somatizing, encountering caregivers imposing a psychological language for understanding distress. Participants were referred from local health care services in Western Stockholm, Sweden. Data were collected between 1997 and 2001 from 37 interviews with ten women. Data were analyzed using a qualitative method with a grounded theory approach to construct an understanding of meaning making from an emic perspective. Participants' restructuring included loss of earlier meanings given to illness, shifts in expressions and healing strategies, and a push toward giving illness and suffering a psychological or psychiatric meaning. Restructuring had in many ways been a disruptive and complicated experience. In their everyday context participants were engaged in bridging gaps between different perspectives of looking upon their illness. They had poor support from their social context in creating coherence between frames of meaning. On the basis of the results the author suggests that Antonovsky's concept of sense of coherence (SOC) may have relevance to the process of restructuring illness meaning, and that constructing coherence between experience, expression, past, and new meanings given to illness may be significant for patients' recovery. For clinical care, results indicate that restructuring should be done so as not to impose too alien a reordering of the disruptive experiences of illness. With regard to further research, results indicate the importance of gaining insight into how individuals and social and cultural groups make sense of their interaction with caregivers and local health care services.     

The role and meaning of susto in Mexican Americans' explanatory model of type 2 diabetes

This article examines the role and meaning of susto (fright) in Mexican Americans' explanatory model (EM) of type 2 diabetes. This analysis is based on a study of the health beliefs about type 2 diabetes mellitus among Mexican Americans living in El Paso County, Texas, on the U.S.-Mexico border. Susto was described as an event that could change the bodily state, causing a susceptible person to be more vulnerable to the onset of type 2 diabetes after some unspecified time. The study results illustrate the integration of multiple etiologies into Mexican Americans' EMs of diabetes and illustrate how the environment affects the way in which these explanations are manifested. Acculturation of biomedical system beliefs into the traditional Mexican health belief system has resulted in a synthesis of both systems and a blending of the participants' explanation of type 2 diabetes.     

The art of imperfection: contemporary synagogues in Germany and the Netherlands

This article compares the remarkable revival of Jewish religious architecture in Germany and the Netherlands by focusing on two cases in particular: a newly built synagogue centre in Dresden and a renovated synagogue in a small Dutch town. Both structures contain a carefully styled ornament of imperfection that on the surface looks remarkably similar. Although in both cases the ornament can be interpreted as a symbolic comment on the post‐war Jewish presence in Europe, their symbolic meaning and depth differ profoundly. In Dresden, this element primarily has a political meaning meant for the German public, to which the predominantly Russian‐Jewish community is largely indifferent. In the Netherlands, the stylistic creation of imperfection is a more complex, multilayered architectural sign that speaks of aspirations of tradition, continuity, and a particular religious way of being in the world. Building upon these ethnographic reflections, as well as on Richard Sennett's work on architecture and the human body, I interpret these architectural practices as an example of a particular kind of contemporary religiosity which seeks to engage actively with fragmented and unsettled reality, both historically and existentially. This is presented as an alternative to dominant theories of contemporary religion that interpret modern religiosity in terms of authenticity, the sacralization of the self, and the desire for wholeness.     

Susto, Coraje, and Abuse: Depression and Beliefs About Diabetes

Mexican immigrants in the US often incorporate folk beliefs into diabetes etiologies but little is known about the relationship between such beliefs and depression. This study examines the relationship of diabetes beliefs and depression among 404 first- and second-generation Mexican immigrants seeking diabetes care in safety-net clinics in Chicago and San Francisco. We used multivariate linear regression to compare the association of depression with beliefs that susto (fright), coraje (anger), and/or interpersonal abuse cause diabetes, adjusting for gender, age, income, education, diabetes duration, co-morbidities, language preference, and acculturation. We incorporated the belief that abuse causes diabetes based on previous ethnographic research. Individuals reporting belief that abuse contributes to diabetes were significantly more likely to report symptoms of depression before (β?=?1.37; p?相似文献   

Attitudes toward genetic testing for cancer risk after genetic counseling and decision support: a qualitative comparison between hereditary cancer types

This study aimed to qualitatively assess individuals' attitudes toward genetic testing for cancer risk after genetic counseling and decision support. As part of a larger study, 78 women considering genetic testing for hereditary breast/ovarian cancer (HBOC) risk and 22 individuals considering genetic testing for hereditary nonpolyposis colorectal cancer (HNPCC) completed an open-ended table of their perceived pros and cons of genetic testing. The most frequently reported pros were "to help manage my risk of developing cancer," "to help my family," and "to know my cancer risk." With regards to risk management, the HBOC group perceived genetic testing as most helpful in informing their general risk management practices, while the HN-PCC group focused on the potential to clarify their need for bowel cancer screening, suggesting that patients' perceptions of the benefits of genetic testing may differ across cancer syndromes. Individuals in both groups expressed concern about the potential psychological impact of genetic testing. We also found that some affected individuals may not fully comprehend the meaning of their potential test results. Eliciting patients' perceived pros and cons during genetic counseling is likely to be a valuable tool for improving patient care. This data also provides an improved evidence base for the development of patient education tools.     

Collective motion and cannibalism in locust migratory bands

Plagues of mass migrating insects such as locusts are estimated to affect the livelihood of one in ten people on the planet [1]. Identification of generalities in the mechanisms underlying these mass movements will enhance our understanding of animal migration and collective behavior while potentially contributing to pest-management efforts. We provide evidence that coordinated mass migration in juvenile desert locusts (Schistocerca gregaria) is influenced strongly by cannibalistic interactions. Individuals in marching bands tend to bite others but risk being bitten themselves. Reduction of individuals' capacity to detect the approach of others from behind through abdominal denervation (1) decreases their probability to start moving, (2) dramatically reduces the mean proportion of moving individuals in groups, and (3) significantly increases cannibalism. Similarly, occlusion of the rear visual field inhibits individuals' propensity to march. Abdomen denervation did not influence the behavior of isolated locusts. When within groups, abdominal biting and the sight of others approaching from behind triggers movement, creating an autocatalytic feedback that results in directed mass migration. This "forced march" driven by cannibalistic interactions suggests that we need to reassess our view of both the selection pressure and mechanism that can result in the coordinated motion of such large insect groups.     

The vision of recovery today: what it is and what it means for services

In the past, practice in mental health was guided by the belief that individuals with serious mental illnesses do not recover. The course of their illness was either seen pessimistically, as deteriorative, or optimistically, as a maintenance course. Research over the past thirty to forty years has indicted that belief and shown that a vision of recovery can be achieved for many individuals. People with serious mental illnesses have themselves published accounts of their own recovery as well as advocated for the development of recovery promoting services. In North America and other regions, policies have been developed to make recovery the guiding vision of services. Today, particularly in the United States, much effort is going into the transformation of services and systems to achieve recovery outcomes. Despite these trends, the idea of recovery remains controversial and, some say, even illusory. This article clarifies the meaning of the term "recovery", reviews the research and first person accounts providing a rationale for recovery, and sets out implications for developing recovery oriented services.     

The embodied liminalities of occupational overuse syndrome: Medical anthropology quarterly

Drawing on interviews with sufferers of OOS (occupational overuse syndrome) in Aoteraoa/New Zealand, this article explores the liminalities associated with OOS and the ways in which this liminality is embodied. While successful rehabilitation could lead back to employment, the respondents' fragility while living with OOS and its accompanying social stigma render such rehabilitation both literally and symbolically "out of reach". Their situations reveal social isolation, loss of identities, pain, and functional disability that have been incorporated into renegotiated identities and biographies in which respondents have become exquisitely self-absorbed, exercising constant bodily surveillance and discipline in order to manage their symptoms. We suggest that this problematic extends beyond biographical disruption to encompass the concept of injury to an embodied sense of integrity for people who were notable prior to their affliction for their reputations as extremely competent and conscientious workers. The embodied meaning of OOS in this environment is not so much to have fallen "out of culture" as Hilbert (Ewan et al. 1991) suggests, but to be liminal in Turner's sense of "threshold people" (Turner 1969:56) "ground down to a uniform condition to be fashioned anew."