'Beyond being': emergent narratives of suffering in Vietnam

Intertwining ethnographic and literary accounts, this article explores the mutual relationship between suffering and agency. The article describes how young Vietnamese women use narrative to find meaning in the suffering that a late-term abortion causes. Seeking to further develop anthropological use of the concept of social suffering, the article argues that existing scholarship has tended to neglect the importance of human agency and imagination, hinging as it does on suffering as entrenched within structural forces. The article contends that this neglect must be understood in the context of the particular epistemological and ethical conditions under which anthropological studies of human suffering are produced, and that closer attention to the human engagements out of which ethnographic accounts are fashioned may bring into analysis not only the harm that social forces can inflict on people, but also their capacities for action and imagination.     

Migration and mental illness: What role do traditional childhood socialization practices play?

Interpretations of studies which show a correlation between migration and mental illness generally focus on sociocultural variables while giving scant attention to determinants of cognitive-personality orientations. This article examines childhood socialization practices as a key variable for comparing points of psychological stress between the traditional rural culture and the post-industrial urban culture. The hypothesis that harsh and restrictive childhood socialization practices foster the development of a cognitivepersonality orientation which increases the likelihood of maladaptive responses to culture change is illustrated by anthropological and psychological data obtained from Sicilians living in Sicily, the U.S.A. and Australia. Suggestions are given for minimizing the mental health risks involved during the critical transition period following migration.     

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.     

Global Mental Health and Adolescent Anxiety: Kin,Care and Struggle in New Mexico

While recent developments within the field of global mental health have illuminated the reality of serious mental health difficulties worldwide, particularly in low-income settings, research that focuses on children and adolescents remains underdeveloped. This is especially the case with respect to ethnographic studies of lived experience of adolescents diagnosed with serious mental health conditions. Drawing from an interdisciplinary study of adolescents in New Mexico who were afflicted with a broad range of disorders according to contemporary research diagnostic criteria, this article focuses on anxiety-related conditions with respect to subjective experience and social–ecological contexts of living with such conditions. We offer preliminary observations regarding the value of linking ethnographic and research diagnostic data to address questions of resilience, endurance, capacity and struggle. These observations are intended as the basis for the formulation of more precise hypotheses about adolescent anxiety, kin, and care under conditions of structural violence marked by psychological, residential, and intergenerational adversity.     

Giving an Account of One’s Pain in the Anthropological Interview

In this paper, I analyze the illness stories narrated by a mother and her 13-year-old son as part of an ethnographic study of child chronic pain sufferers and their families. In examining some of the moral, relational and communicative challenges of giving an account of one’s pain, I focus on what is left out of some accounts of illness and suffering and explore some possible reasons for these elisions. Drawing on recent work by Judith Butler (Giving an Account of Oneself, 2005), I investigate how the pragmatic context of interviews can introduce a form of symbolic violence to narrative accounts. Specifically, I use the term “genre of complaint” to highlight how anthropological research interviews in biomedical settings invoke certain typified forms of suffering that call for the rectification of perceived injustices. Interview narratives articulated in the genre of complaint privilege specific types of pain and suffering and cast others into the background. Giving an account of one’s pain is thus a strategic and selective process, creating interruptions and silences as much as moments of clarity. Therefore, I argue that medical anthropologists ought to attend more closely to the institutional structures and relations that shape the production of illness narratives in interview encounters.     

Accusations of Genital Theft: A Case from Northern Ghana

Occurrences of panic attacks associated with belief in genital retraction have been described in the anthropological and psychological literature in terms of culture bound reactive syndromes. Similar phenomena occur widely in West Africa, where they are reported as cases of penis snatching. Explanations for these phenomena range from the biomedical emphasis on pathology to the social psychological emphasis on altered perceptual sets. This paper provides a narrative of an accusation of genital theft in a rural West African settlement. Drawing from ethnographic information, it will be argued that the case is best explained in light of social relations, definitions for in-groups and out-groups, and local knowledge concerning witchcraft and divination. Local explanations for the case conform to both biomedical and social psychological models.     

Associations between social jetlag and mental health in young people: A systematic review

ABSTRACT

Adolescence and early adulthood (collectively categorized as “young people”) is a transitional period associated with a number of key physiological, social and psychological changes. Sleep difficulties, notable in this age group, may adversely affect physical and mental health. Of interest is the impact of the natural shift in young people towards a more evening-type sleep pattern (chronotype), whilst social constraints encourage early waking to fit with school/work timings. This leads to a misalignment in sleep timing between weekdays and weekends, known as social jetlag, which may contribute to emerging mental health difficulties seen during this age group. A systematic literature review was undertaken to investigate the association between social jetlag and mental health outcomes.

Systematic searching of electronic databases (The Cochrane Library; PsycINFO; CINAHL; Scopus; and PubMed), grey literature and review of reference lists identified seven studies which assessed associations between social jetlag and mental health outcomes in young people. Quality appraisal was completed using the Appraisal Tool for Cross-Sectional Studies.

Findings appeared equivocal; however significant associations were revealed with social jetlag associated with clinical depression and seasonal depression, in female participants and high latitude regions. Quality of included studies was moderate (10–13 criteria met). A lack of homogeneity between study methodologies precluded the conduct of a meta-analysis.

The ambiguous results found may result from confounding factors including non-comparable methods of measuring social jetlag and mental health both in this age group and the selected studies. Future research should address a lack of homogeneity through the development of an interdisciplinary core outcome set, and agreement on a standardized measure and calculation for social jetlag.     

The Cultural Construction of Mental Illness in Prison: A Perfect Storm of Pathology

Large numbers of individuals in U.S. prisons meet DSM criteria for severe psychiatric disorder. These individuals also have co-occurring personality and substance abuse disorders, medical conditions, and histories of exposure to social pathologies. Based on nine months of ethnographic fieldwork in a U.S. prison, focusing on staff narratives, I utilize interpretivist and constructivist perspectives to analyze how mental health clinicians construct psychiatric disorder among inmates. Discrete categorization of disorders may be confounded by the clinical co-morbidities of inmates and the prison context. Incarcerated individuals’ responses to the institutional context substantially inform mental health staffs’ illness construction and the prison itself is identified as an etiological agent for disordered behaviors. In addition, diagnostic processes are found to be indeterminate, contested, and shaped by interactions with staff. Analysis of illness construction reveals that what is at stake for clinicians is not only provision of appropriate treatment, but also mandates for the safety and security of the institution. Enmeshed in these mandates, prison mental health becomes a particular local form of psychiatric knowledge. This paper contributes to anthropological approaches to mental disorder by demonstrating how local contexts mediate psychiatric knowledge and contribute to the limited ethnographic record of prisons.     

Understanding the Rise of Consumer Ethnography: Branding Technomethodologies in the New Economy

ABSTRACT   In this article, I aim to contribute to the ongoing discussion on the changing public role of anthropology by exploring the rise of branded ethnographic practices in consumer research. I argue that a juncture in the "New Economy"—the conjoining of corporate interest in branding, technology, and consumers, with vast social changes—may explain the rapid growth of ethnography for consumer research and predict its future direction. An analysis of branded propaganda from ethnographic vendors that claim their technology-enhanced methods innovate "classic" anthropological practices discloses the way corporations employ technologically mediated means to focus on the reflexive self in consumer research. In this analysis, I reveal that technological methodologies are central to the production of branded ethnographic practices, as forms of branding and technology legitimate consumer–corporate flows of interaction. The conclusion raises awareness to the ways in which modern branding practices reconstruct anthropology in public discourse. [Keywords: branding, consumer research, ethnography, reflexivity, technology]     

Urban health and pharmaceutical consumption in Delhi, India

This paper interrogates the routine and unproblematic use of terms such as 'self-medication' in biomedical and anthropological discourse. A typical depiction of the social factors that explain the practice of 'self-medication' in India is to put together the supply side factors (such as protection offered by the government for the production of generic drugs, especially in the small scale sector, and expansion of the number of drug store outlets), with the increasing demand for allopathic drugs. The paper provides an ethnographic account of the intricate connections between households and biomedical practitioners in urban neighbourhoods in Delhi. It breaks away from the conventional opposition drawn between the practices of physicians and the beliefs of their patients, and suggests that what constitutes the medical environments of these neighbourhoods is the product of medical practices, household economies and concepts of disease. Thus pharmaceutical use is determined as much by practices of dispensation and by how practitioners understand what constitutes therapy as by household understanding of the normal and the pathological. This paper uses both quantitative data and narrative interviews to provide an in-depth understanding of the circulation of pharmaceuticals within the life worlds of the urban poor.     

Reproduction as spiritual kin work: Orthodoxy, ivf, and the moral economy of motherhood in greece

Bringing gender and kinship studies together with an anthropology of religion, in this article I demonstrate how urban Greek couples and clinical practitioners in the middle 1990s proceeded with in vitro fertilization (IVF) in the absence of government regulations, and did so with reference to cultural beliefs and social relations consistent with Greek Orthodox religious practice. Drawing on ethnographic observations at an Athens IVF clinic as well as on interviews with former patients, I argue that Athenian women, in particular, engage IVF as a kind of spiritual kin work, normalizing the use of medical techniques with reference to ideologies of motherhood that treat it as a woman’s moral achievement and as a source of womanly suffering. Since the period of ethnographic research described here, and despite disapproval of the Greek Orthodox Church, legislation regulating the use of IVF and other methods of medically assisted reproduction has become law. This article reconciles how the Church can officially reject medically assisted means of reproduction that Athenian users have normalized with reference to spiritual beliefs and practices.     

Applying evolutionary anthropology

Evolutionary anthropology provides a powerful theoretical framework for understanding how both current environments and legacies of past selection shape human behavioral diversity. This integrative and pluralistic field, combining ethnographic, demographic, and sociological methods, has provided new insights into the ultimate forces and proximate pathways that guide human adaptation and variation. Here, we present the argument that evolutionary anthropological studies of human behavior also hold great, largely untapped, potential to guide the design, implementation, and evaluation of social and public health policy. Focusing on the key anthropological themes of reproduction, production, and distribution we highlight classic and recent research demonstrating the value of an evolutionary perspective to improving human well‐being. The challenge now comes in transforming relevance into action and, for that, evolutionary behavioral anthropologists will need to forge deeper connections with other applied social scientists and policy‐makers. We are hopeful that these developments are underway and that, with the current tide of enthusiasm for evidence‐based approaches to policy, evolutionary anthropology is well positioned to make a strong contribution.     

Ways of Asking,Ways of Telling

The interpretive understanding that can be derived from interviews is highly influenced by methods of data collection, be they structured or semistructured, ethnographic, clinical, life-history or survey interviews. This article responds to calls for research into the interview process by analyzing data produced by two distinctly different types of interview, a semistructured ethnographic interview and the Structured Clinical Interview for DSM, conducted with participants in the Navajo Healing Project. We examine how the two interview genres shape the context of researcher-respondent interaction and, in turn, influence how patients articulate their lives and their experience in terms of illness, causality, social environment, temporality and self/identity. We discuss the manner in which the two interviews impose narrative constraints on interviewers and respondents, with significant implications for understanding the jointly constructed nature of the interview process. The argument demonstrates both divergence and complementarity in the construction of knowledge by means of these interviewing methods.     

Kinship on the waterfront: logistics labour in a global port

This article examines how kinship forms a contested element of labour under capitalist distribution. The focus of the article is on a thriving Spanish container port where the dockworker collective has been steadily growing since the multinational companies first arrived in the 1970s. In the wake of containerization – a standardized system of freight transport based on the intermodal shipping container – dock work has been revalued and become attractive in an area otherwise characterized by high unemployment rates and below-average salaries. Drawing on ethnographic research, the article analyses how unionized dockworkers are met with stigmatization from the general public and criticized for their intergenerational access to ‘container capital’. The article contributes to current anthropological debates around the role of labour under global capitalism by tracing the links between kinship and labour in the making of a global port.     

Shifting Urban Margins: Accessing Unequal Spaces of Ageing and Care in Zanzibar and Muscat

ABSTRACT

Older people constitute a growing proportion of the urban population and are encountered in all kinds of spaces and neighbourhoods across cities. This article argues that urban seniority and elderly care are a fruitful, new lens to study how inhabitants on the social margins create urban space and social cohesion. This article draws on ethnographic research in the cities of Zanzibar, Tanzania, and Muscat, the capital of Oman. Many older inhabitants of cities experience frailty, serious health problems, or even disabilities and are no longer able to work or make a living, which pushes them towards the social margins. The ethnographic examples and reflections in this article illustrate, first, how cities can be investigated from the perspective of social and spatial marginality. Second, they show how urban dwellers’ social positions can shift between the margins and centres of an urban society depending on their health and access to unequal spaces of ageing and care. And third, the paper analyses how some elders respond to marginality by taking up transnational and cosmopolitan agency.     

Hacking anthropology

This essay outlines how the ‘hack’ might offer a model for anthropological research in the face of the distributed relations evidenced by digital data. The argument builds on fieldwork with citizens and activists and looks at their attempts to understand and make use of the data produced by energy sensors and monitors. Drawing on their experiences, I suggest that ‘the hack’ emerges as an important form of practice that helps people navigate the place of data in social relations. Taking the hack not just as ethnographic observation but also as a methodological proposition, I use my ethnographic material on the practice of the hack to reconsider the anthropological challenge of doing ethnography of processes that are only perceptible through numerical or digital data. To explore the value of the hack for anthropology, I introduce an example of an attempt to do ethnography in the mode of the hack. The essay ends with reflections on how the hack might provide us with new ways of getting to grips with the anthropological implications of systemic and emergent relations that are both brought to light and remade through data.     

One operational definition by population: the need for local evaluations of frailty

Frailty is a health problem that increases the probability of developing adverse health outcomes in the elderly. A frequently used way to operationalize frailty is the construction of a frailty index, which is built from the addition of several health deficits that describe biological aging. However, there is no consensus about the number of health deficits for building a frailty index and about which deficits must be chosen. This lack of a standardized frailty index is assumed to be an obstacle for the advancement of research on frailty. The focus of the present article is to propose a theoretically plausible alternative way of operationalizing frailty by means of frailty indexes composed of deficits selected at a local level. These deficits would therefore be different for each given population. This "anthropological approach" is on the opposite side from current trends in frailty research, which is characterized by the search for a standardized operational definition of frailty. The anthropological approach would generate more reliable data by taking into account the specificity of the population to be studied for selecting frailty deficits. In this approach, emotions, motives, and beliefs are as important to determine individuals' health vulnerability as chronic diseases and physical function. Physiological anthropologists are well positioned to contribute to research on frailty by carrying out studies on the selection of the best deficits to operationalize frailty in different populations, with different socio-cultural determinants of health, and living in different environmental life spaces.     

Strategies to improve the evidence base of animal-assisted interventions

Animal-assisted interventions (AAIs) reflect an extraordinary opportunity to improve mental health given the special role that animals (pets) occupy in everyday life and general public receptivity to animals. To enhance the evidence-base for AAIs, four recommendations are discussed: (a) conduct more well-designed studies, including the use of a broader array of methodologies; (b) make explicit “small theories” about precisely why and how human-animal interaction changes health and well-being; (c) increase laboratory-based studies of processes likely to underlie therapeutic applications; and (d) develop a strategic plan to guide AAI research, a means of implementing that plan, and ways of monitoring progress to ensure implementation has had impact on AAI research. There is enormous potential for AAI to overcome many obstacles of more traditional physical and mental health services, but developing that potential depends on establishing a stronger evidence base.     

Oligoelements and isotopic geochemistry: a multidisciplinary approach to the reconstruction of the paleodiet

Man's biological evolution, state of health and lifestyle are closely associated with dietary changes. The methods for acquiring useful information on the diet of our ancestors are an important aspect of anthropological research; hence it was retained interesting to apply the oligoelement and isotopic techniques in parallel on the same sample, in order to compare the two methodologies, construct a complete nutritional picture, and compare the analytical results with the ancient literary sources and with the findings from archaeological excavations.