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Defining, Assessing, and Treating Stress-Related Disorders across Cultures
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Defining, Assessing, and Treating Stress-Related Disorders across Cultures

A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601). This special issue belongs to the section "Health Communication and Informatics".

Deadline for manuscript submissions: closed (30 June 2022) | Viewed by 15425

Special Issue Editors

Dr. Clare Killikelly

E-Mail Website
Guest Editor
Department of Psychology, University of Zurich, 8006 Zurich, Switzerland
Interests: grief, loss and trauma; cross-cultural psychology; psychotherapeutic interventions for grief and trauma; mental health of migrants and refugees
Dr. Eva Heim

E-Mail Website
Guest Editor
Department of Psychology, University of Zurich, 8006 Zurich, Switzerland
Interests: e-mental health; cultural clinical psychology

Special Issue Information

Dear Colleagues,

In 2019, the International Classification of Diseases (ICD-11) introduced a new categorization of mental disorders, namely, stress-related disorders, or disorders that arise due to single or multiple stressful life events. Post-traumatic stress disorder (PTSD) and adjustment disorder (AjD) are included in this category along with newcomers complex PTSD and prolonged grief disorder (PGD). In addition to clear guidelines for core symptoms and accessory symptoms, the WHO working groups specified a cultural caveat, that symptoms of disorder must deviate from cultural norms. Presently, the cultural norms for stress-related disorders across different cultures have not been systematically investigated (barring PTSD). This Special Issue seeks to amalgamate recent, innovative research exploring the definition, assessment, and treatment of stress-related disorders across cultures.

Dr. Clare Killikelly
Dr. Eva Heim
Guest Editors

Manuscript Submission Information

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Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. International Journal of Environmental Research and Public Health is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2500 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • ICD-11 stress-related disorders
  • Cultural adaptation
  • Cultural norms
  • Posttraumatic stress disorder
  • Prolonged grief disorder
  • Adjustment disorder

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Published Papers (4 papers)

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Research

26 pages, 1099 KiB  
Article
Still Standing Inside: A Local Idiom Related to Trauma among Namibian Speakers of Khoekhoegowab
by Milena Claudius, Elizabeth N. Shino, Sylvanus Job, Daniel Hofmann and Amber Gayle Thalmayer
Int. J. Environ. Res. Public Health 2022, 19(21), 14323; https://doi.org/10.3390/ijerph192114323 - 2 Nov 2022
Cited by 3 | Viewed by 3208
Abstract
Euro-centric psychiatric conceptualizations often ignore the interplay of local with universal factors in psychological suffering. Emic, locally focused perspectives can enrich etic knowledge to provide culturally sensitive care and to better elucidate the role of culture in mental illness. This study explored the [...] Read more.
Euro-centric psychiatric conceptualizations often ignore the interplay of local with universal factors in psychological suffering. Emic, locally focused perspectives can enrich etic knowledge to provide culturally sensitive care and to better elucidate the role of culture in mental illness. This study explored the idiom Tsûsa ǃNaeǃkhais xa hâǃnâ/mâǃnâ/ǂgâǃnâhe hâ (a terrible event has entered a person and remains standing inside), which was understood to relate to experiences of trauma and post-traumatic stress, among speakers of Khoekhoegowab, a southern-African click language. Semi-structured interviews were conducted with 16 participants from six urban and rural communities in Namibia. Questions probed perceptions of the idiom in terms of etiology, course, and risk and resilience factors from a socio-ecological framework. Five key themes were identified using thematic analysis: origin in a shocking event; intrusive recurrence of memories, “it keeps on coming back”; the close interplay between mental and physical suffering; the importance of active engagement in healing through prayer and acceptance; and the role of the community in both alleviating and amplifying distress. Our findings highlight local norms and strategies for adaptive coping, and the benefits of exploring local idioms to elucidate the braiding together of universal and cultural elements in psychological distress. Full article
(This article belongs to the Special Issue Defining, Assessing, and Treating Stress-Related Disorders across Cultures)
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16 pages, 379 KiB  
Article
Do Gender and Country of Residence Matter? A Mixed Methods Study on Lay Causal Beliefs about PTSD
by Caroline Meyer, Louisa Heinzl, Christina Kampisiou, Sofia Triliva, Christine Knaevelsrud and Nadine Stammel
Int. J. Environ. Res. Public Health 2022, 19(18), 11594; https://doi.org/10.3390/ijerph191811594 - 14 Sep 2022
Viewed by 1967
Abstract
Laypersons’ causal beliefs about mental disorders can differ considerably from medical or psychosocial clinicians’ models as they are shaped by social and cultural context and by personal experiences. This study aimed at identifying differences in causal beliefs about post-traumatic stress disorder (PTSD) by [...] Read more.
Laypersons’ causal beliefs about mental disorders can differ considerably from medical or psychosocial clinicians’ models as they are shaped by social and cultural context and by personal experiences. This study aimed at identifying differences in causal beliefs about post-traumatic stress disorder (PTSD) by country and gender. A cross-sectional, vignette-based online survey was conducted with 737 participants from Germany, Greece, Ecuador, Mexico, and Russia. Participants were presented with a short unlabeled case vignette describing a person with symptoms of PTSD. Causal beliefs were assessed using an open-ended question asking for the three most likely causes. Answers were analyzed using thematic analysis. Afterwards, themes were transformed into categorical variables to analyze differences by country and by gender. Qualitative analyses revealed a wide range of different causal beliefs. Themes differed by gender, with women tending to mention more external causal beliefs. Themes also differed between the five countries but the differences between countries were more pronounced for women than for men. In conclusion, causal beliefs were multifaceted among laypersons and shared basic characteristics with empirically derived risk factors. The more pronounced differences for women suggest that potential gender effects should be considered in cross-cultural research. Full article
(This article belongs to the Special Issue Defining, Assessing, and Treating Stress-Related Disorders across Cultures)
17 pages, 395 KiB  
Article
Coping with Trauma and Symptoms of Post-Traumatic Stress Disorder: Exploring Intentions and Lay Beliefs about Appropriate Strategies among Asylum-Seeking Migrants from Sub-Saharan Africa in Germany
by Freyja Grupp, Marie Rose Moro, Sara Skandrani and Ricarda Mewes
Int. J. Environ. Res. Public Health 2022, 19(3), 1783; https://doi.org/10.3390/ijerph19031783 - 4 Feb 2022
Cited by 5 | Viewed by 3258
Abstract
Asylum-seekers are at high risk of developing post-traumatic stress disorder (PTSD) due to frequent exposure to trauma. We investigated the coping intentions and lay beliefs about appropriate coping strategies among asylum-seekers from Sub-Saharan Africa in Germany. The study applied a methodological triangulation strategy [...] Read more.
Asylum-seekers are at high risk of developing post-traumatic stress disorder (PTSD) due to frequent exposure to trauma. We investigated the coping intentions and lay beliefs about appropriate coping strategies among asylum-seekers from Sub-Saharan Africa in Germany. The study applied a methodological triangulation strategy with a vignette describing symptoms of PTSD. In a quantitative part, asylum-seekers (n = 119) that were predominantly from Eritrea (n = 41), Somalia (n = 36), and Cameroon (n = 25), and a native comparison sample (n = 120) responded to questionnaires assessing coping, traumatic events, and post-traumatic symptoms. In a qualitative part, asylum-seekers (n = 26) discussed coping strategies in focus groups. In the quantitative part, asylum-seekers displayed higher intentions for religious coping, emotional support, and denial compared to the native participants. Asylum-seekers with a higher symptom load expressed lower intentions to seek instrumental support. Asylum-seekers with a lower educational level and those with a higher symptom load expressed higher intentions for substance use. In the qualitative part, we identified three superordinate themes: (a) religion, (b) social support systems, and (c) cognitive strategies. Asylum-seekers expressed coping intentions that are associated with an adaptive response to trauma. Less-educated asylum-seekers with a higher symptom load might constitute a particularly vulnerable group. Full article
(This article belongs to the Special Issue Defining, Assessing, and Treating Stress-Related Disorders across Cultures)
15 pages, 939 KiB  
Article
Examining Cultural Differences in the Associations between Appraisals and Emotion Regulation and PostTraumatic Stress Disorder in Malaysian and Australian Trauma Survivors
by Laura Jobson, Shamsul Haque, Siti Zainab Abdullah, Bryan Lee, Haoxiang Li, Tamsyn Reyneke, Britney Kerr Wen Tan, Winnie Lau and Belinda Liddell
Int. J. Environ. Res. Public Health 2022, 19(3), 1163; https://doi.org/10.3390/ijerph19031163 - 21 Jan 2022
Cited by 16 | Viewed by 5653
Abstract
Appraisals and emotional regulation play a central role in posttraumatic stress disorder (PTSD). Despite research demonstrating cultural differences in everyday appraisals and emotion regulation, little research has investigated the influence of culture on these processes in PTSD. This study examined cultural differences in [...] Read more.
Appraisals and emotional regulation play a central role in posttraumatic stress disorder (PTSD). Despite research demonstrating cultural differences in everyday appraisals and emotion regulation, little research has investigated the influence of culture on these processes in PTSD. This study examined cultural differences in the associations between appraisals, emotion regulation and PTSD symptoms using trauma survivors from an individualistic Western culture (Australia) and a collectivistic Asian culture (Malaysia). Trauma survivors (N = 228; 107 Australian with European cultural heritage, 121 Malaysian with Malay, Indian or Chinese cultural heritage) completed an on-line survey assessing PTSD (PTSD Checklist for the DSM-5 with Life Events Checklist), appraisals (trauma-related, fatalism, cultural beliefs about adversity) and emotion regulation (suppression, reappraisal, interpersonal). The Malaysian group reported significantly greater fatalism, cultural beliefs about adversity, suppression and interpersonal emotion regulation than the Australian group. Greater trauma-specific appraisals, greater suppression, fewer cultural beliefs about adversity, and less use of social skills to enhance positivity were generally associated with greater PTSD symptom severity, with little evidence of cultural group moderating these associations. Interdependent self-construal mediated the relationships between cultural adversity beliefs, enhanced positivity, reappraisal, perspective taking and PTSD symptoms. Independent self-construal mediated the relationships between fatalism and perspective taking and PTSD symptoms. Cultural group did not moderate these indirect effects. Interdependent self-construal mediated the associations between interpersonal regulation strategies of soothing and social modelling with PTSD symptoms for the Malaysian but not the Australian group. These findings demonstrate the importance of considering self-construal and culture in understanding factors associated with PTSD. Full article
(This article belongs to the Special Issue Defining, Assessing, and Treating Stress-Related Disorders across Cultures)
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