April 24, 2008
University of Miami Study Links Culture to Manifestations and Course of Mental Illness
New research by a University of Miami psychologist finds explanation for better outcome of mentally ill patients of Latin ethnicity than those of Anglo backgrounds
CORAL GABLES (April 24, 2008) Criticism and hostility towards a mentally ill relative is significantly higher among Anglo families than among Latinos in the United States. This helps explain why patients with mental illness, who come from Latin cultures have a better outcome than Anglo American patients, according to a study published by University of Miami psychologist, Amy Weisman de Mamani and University of Massachusetts psychologist Jennifer A. Kymalainen.
The findings published this month in the Journal Cultural Diversity and Ethnic Minority Psychology, explains that what is considered desirable conduct varies for different ethnic groups, and family members of a person with mental illness express negative attitudes towards the ill-relative when they fail to live up to culturally desired behaviors and values.
According to Weisman de Mamani, when this occurs, there is a breakdown in communication between family and patient and the harsh and disapproving attitudes that emerge cause stress for the ill persons, which makes them more vulnerable to the disease.
“It’s a fascinating phenomenon that for patients with Schizophrenia the more traditional their families are, the more benign the course for the disease,” Weisman de Mamani said. “In this study, we looked at what happens with these family members that may provide a more adaptive course for the illness”
The report says Anglo American cultural values emphasize independence and responsibility, therefore, within Anglo families, criticism of the individual centers around the desire to see the affected person act in an independent and productive manner. Anglos are much more likely to be critical about a relative not being able to hold a job, or act independently, the study says.
“Among Anglos in the United States, there is this notion that with hard work you can overcome anything, although this can be a healthy attribute, in the context of mental illness it can lead to more criticism and a more severe course for the illness” Weisman de Mamani said.
The report indicates that Latino families emphasize interdependence and family connectedness, thus criticism arises when family unity and harmony is disrupted. “We found that Latinos are more likely to criticize patients for not taking a shower, not interacting, or not showing their emotions,” Weisman de Mamani said.
The researches propose that interconnectedness may encourage Latino families to share some of the blame for the symptoms of the illness, thus becoming more tolerant and compassionate towards the affected individual.
Interestingly, criticism of mentally ill persons among African American families is as frequent as in the Anglo community however, it is not as detrimental. What people in other cultural groups may consider criticism may not be perceived as such by African Americans, Kymalainen said.
“Black patients do not appear to take criticism from family members as personally,” Kymalainen said. “Although communication tends to break down around some of the same issues as Latino families, blacks may interpret the criticism as a sign of family concern,”
Weisman de Mamani and Kymalainen first became intrigued by a series of studies conducted by the World Health Organization beginning in the late 1960s. They found-counter intuitively- that while prevalence of the disease was pretty stable worldwide, the course was much more benign in traditional cultures. Consequently, they started looking at the emotional climate of families in traditional cultures and asked themselves: are families more supportive and empathic in these societies? The result was an extensive literature review of three decades of research about Schizophrenia in different cultures.
The researchers found that while all cultures value family, what is seen as most important in different societies comes through in the way they react towards an ill relative. The study concludes that understanding cultural patterns for patients with Schizophrenia can predict relapse and stabilization of the affected individual, and suggest that if clinicians and researches focus family interventions on specific issues related to the patients’ cultural norms; it can greatly improve the patients’ outcome.
“It’s really important to attend to cultural factors which are essential in determining where family intervention could have greatest impact,” Kymalainen said.
Weisman de Mamani has recently taken the research described in this article along with her earlier research to develop a 15-session, family focused, culturally informed treatment for schizophrenia. A study to evaluate this treatment is currently underway at the University of Miami. The study is sponsored by NIH and enrollment is open to eligible English and Spanish speaking families. Interested parties should contact the Schizophrenia Family Study at (305)284-5455.
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Marie Guma-Diaz
Media Relations Officer
305-284-1601
m.gumadiaz@umiami.edu
