Search PubMed⌕ Search

Biomedical subjects

J Westermeyer

Publications and source records attributed to J Westermeyer.

At least 91 records · Page 5Linked to original sources
PubMed1986

Two self-rating scales for depression in Hmong refugees: assessment in clinical and nonclinical samples.

An exploratory cross-cultural study was undertaken of two widely used self-rating scales: the Zung and the Depression Scale on the 90 Item Symptom Checklist, or SCL-Depression. Both scales were translated into Hmong and tested in two samples of Hmong refugees in the U.S.A. One sample (n = 86) consisted of a field survey of all Hmong people living in Minnesota. Of the 86, 15 sought treatment and were diagnosed as having major depression during the year following their self rating, so that a comparison of patients' scores with nonpatients' scores was possible. The other sample consisted of another 51 Hmong psychiatric patients with major depression. This second group was also assessed by four psychiatric rating scales (i.e. Hamilton Depression Scale, brief Psychiatric Rating Scale, Inpatient Multidimensional Rating Scale, and Nurse's Observation Scale for Inpatient Evaluation) and two measures of treatment intensity (i.e. number of visits, duration of treatment). In the general Hmong population (n = 86), both self-rating scales were highly intercorrelated, and strongly associated with patient status. In the patient sample (n = 51), only the SCL-Depression showed any correlations with psychiatric rating scales or with treatment variables. This is contrary to the anticipated outcome, as it had been expected that the Zung would perform better than the SCL-Depression. In addition, duration of treatment was inversely correlated with the SCL-Depression, also opposite to our prediction. Probable causes for these unexpected results are presented. An item analysis was undertaken, comparing 71 Hmong survey subjects who were not treated for depression with 51 Hmong psychiatric patients who were treated for depression. Most Zung and SCL-Depression items showed significantly higher symptom levels in the depressed patients. However, non-depressed controls unexpectedly reported significantly higher symptom levels on certain items. No significant differences were observed on several Zung and SCL items. These unexpected findings are discussed in light of the refugee's adjustment and experience.

Cross-Cultural Comparison↗
PubMed1985

Psychiatric diagnosis across cultural boundaries.

Diagnosis across cultural boundaries has become a practical rather than an esoteric matter as migration, the number of effective psychiatric therapies, and access to psychiatric care have increased. Cross-cultural diagnosis involves such theoretical considerations as diagnostic categories, pathoplasticity of psychiatric disorder, so-called culture-bound syndromes, "emic" (intracultural) versus "etic" (cross-cultural) conceptual frameworks, and different reporting of symptoms and expression of signs from one cultural group to another. Important clinical issues include distinguishing cultural belief systems from delusions and understanding the special problems of minority, migrant, and refugee patients.

Cross-Cultural Comparison↗
PubMed1985

Public health aspects of mental health: the last 75 years of the American Journal of Public Health.

The American Journal of Public Health has reflected the relationship of public health to the field of mental health over its 75-year history. The earliest volumes of the Journal addressed movements and concerns within public mental health. Quantitative analysis of mental health articles shows wide fluctuations over the last 75 years, probably due to variations in federal funding for mental health research. Topical emphases in the Journal have included social issues and improved mental health, the contributions of epidemiological studies, and technological advances in prevention and treatment.

History, 20th Century↗
PubMed1984

Cross-cultural aspects of alcoholism in the elderly.

Thus far, we know relatively little about alcoholism among the elderly across cultures. However, extrapolation from available reports suggests certain common features across cultures. These include an inverse relationship between age and problem-producing dosages, increased risk of elderly alcoholics to trauma, greater efficacy of milieu changes with age, and a concentration of elderly alcoholics in cities. Conversely, certain other aspects of aging that vary across cultures may influence alcoholism in the elderly. These include the biological concomitants of aging, social status and the role of the elderly in the society (including integration or isolation of widowed persons), dealing with problematic behavior in the elderly, and patterns of alcohol use by the elderly. Future strategies for researching alcoholism among the elderly are suggested. It is suggested that cultural norms and values, as well as social policy, ameliorate or exacerbate alcohol-related problems among the elderly.

Aged↗
PubMed1984

Acculturation and mental health: a study of Hmong refugees at 1.5 and 3.5 years postmigration.

This study of Hmong refugees at 1.5 and 3.5 years following arrival in the United States showed considerable improvement on psychiatric self-rating scales. Social changes over the 2 year interim (including a high unemployment rate) were few. Earlier premigration and postmigration variables correlated with high symptom levels at 1.5 years were not correlated with these symptoms at 3.5 years. Events in the acculturation process which accompany, and perhaps account for some of these observations are indicated.

Acculturation↗
PubMed1984

The addiction hospital: current status and an assessment.

Hospitals have provided treatment for drug and alcohol dependence for at least 200 years, although the hospital solely devoted to this problem has been a creature of this century. These large institutions served to isolate or 'quarantine' such patients--a valuable public health role when the number of addicts were few. They also facilitated research and education regarding drug and alcohol dependence. While these quarantine, research and training functions have continued to a limited degree, their expense and low treatment efficacy has limited their applicability in most societies today. Smaller, shorter-stay units in general hospital, together with day programs and out-patient treatment, have largely replaced this older treatment approach. Some of these outmoded hospital facilities have been modified as low security prisons for addicts convicted of drug offenses.

Alcoholism↗
PubMed1984

Symptom change over time among Hmong refugees: psychiatric patients versus nonpatients.

Most Hmong refugees in Minnesota were assessed in September, 1977, using two self-rating scales (Zung Scale for Depression and 90-item Symptom Checklist). The same group was restudied two years later. During 12 months of 1977-78, psychiatric services were offered to this population. Those seeking psychiatric care were compared with those who did not. These data indicate that the patients reported considerably more symptoms than nonpatients in 1977 prior to receiving care. The patients showed more improvement than the nonpatients between 1977 and 1979.

Adult↗
PubMed1984

Evaluation of a medical interviewing course. Use of the helping relationship inventory.

Changes in beginning medical students' preferred interview responses appear attributable to a course that emphasizes communication techniques for developing patient rapport. For each of five successive classes, pre/postcourse preferences were obtained for alternative response modes (categorized as understanding, probing, interpretive, supportive, and evaluative. Analysis indicated significant increases in students' preferences for understanding responses and decreases in preferences for evaluative responses (p less than .001). Changes are in the desired direction with respect to course goals, since rapport is generally enhanced by conveying understanding and refraining from premature evaluation. Effects on response preferences of some instructor characteristics are analyzed. Implications for health professions education and research are discussed.

Analysis of Variance↗
PubMed1984

Economic losses associated with chronic mental disorder in a developing country.

This study was undertaken in a society without psychiatric services to assess the economic losses associated there with major mental disorder. Such data are important in assessing the cost/benefit of services for major mental disorders. A survey was conducted in 27 representative villages of Laos, each containing about 200-300 people; 35 mentally ill subjects were identified. Data were obtained on expenditure for treatment, loss of productivity, and other economic losses (eg., destruction of property); demographic data and clinical rating scales were also obtained, and compared with economic variables. The data show wide variability in expenditures for treatment, but losses of productivity were consistently high; acute losses, while impressive due to their suddeness and obvious wastefulness, were comparatively small relative to others. Demographic data were not associated with loss in productivity. Certain psychopathological parameters, ie., more psychopathology, less productivity, were inversely correlated with productivity. Psychosocial function scales were strongly and directly correlated with productivity.

Adolescent↗
PubMed1984

The role of ethnicity in substance abuse.

Ethnicity can be a confusing concept. In part, it includes inherited characteristics such as race. Certain other aspects are learned, such as religion, language, attitudes, values, or customs. National origin of oneself or one's kin can be a component of ethnicity. Group affiliation and participation in certain ritual and ceremony are also involved in ethnicity. Substance abuse and dependence may undermine certain aspects of ethnicity and ethnic affiliations, by interfering with traditional values, attitudes, preferred behaviors, and interpersonal relationships. Substance abuse leads to the evolution of new values, attitudes and behaviors. These are remarkably similar (though not identical) from one chemically dependent person to another. In some cases the chemically dependent person remains a social isolate, while in other cases the individual joins with others to create a subculture in which the drug or alcohol centered values, attitudes and behaviors are shared. Treatment for alcoholism or drug abuse--is successful--produces crisis in ethnic identity for many people. Drug centered values and behaviors are directly confronted in the treatment process, and affiliation with alcohol or drug subcultures is specifically undermined. This may create a state of anomie--with its attendant confusion, anxiety, and loss. Out of this turmoil some individuals resume their original, childhood ethnic identities and affiliations (though often more accentuated than before). Others assume new ethnic identities or affiliations.

Anomie↗
PubMed1983

Psychiatric problems among adolescent Southeast Asian refugees. A descriptive study.

When first faced with evaluating and/or treating a Southeast Asian adolescent psychiatric patient, the American therapist may be overwhelmed by the vast cultural differences. We have reviewed 28 cases of adolescents encountered in a psychiatric setting in order to provide a description of their presenting complaints and problems. Diagnostic categories and demographic characteristics are described, as well as current areas of needs for adolescent psychiatric patients from Southeast Asia.

Adolescent↗
PubMed1983

Refugees who do and do not seek psychiatric care. An analysis of premigratory and postmigratory characteristics.

Social psychiatric research can provide information about the role of interpersonal and societal factors in the genesis of psychiatric disorder. This discipline relies heavily on "experiments in nature" which expose a large number of people to a potentially pathological social stimulus. It also depends in large part upon the study of nonpatients to serve as a comparative group for patients. Both conditions are met in this study of Hmong refugees from Indochina. While the population and the event are esoteric to some extent, their experiences of sudden sociocultural change, geographic migration, role discontinuity, identity crisis, and massive loss are common experiences among many psychiatric patients, regardless of their origin. Thus this study contributes to our understanding regarding the social genesis of psychiatric disorder. This prospective study of refugees to the United States was undertaken among the Hmong population in Minnesota (N = 97) during 1977. Subsequently 17 of this group became psychiatric patients over a 12-month period. Premigration and postmigration factors associated with patient status are described. Hypotheses are offered regarding those postmigration experiences or social strategies which favored or prevented psychiatric status.

Adaptation, Psychological↗