Effects of Increased Psychiatric Treatment Contact and Acculturation on the Causal Beliefs of Chinese Immigrant Relatives of Individuals With Psychosis

Abstract

Encounters with Western psychiatric treatment and acculturation may influence causal beliefs of psychiatric illness endorsed by Chinese immigrant relatives, thus affecting help-seeking. We examined causal beliefs held by forty-six Chinese immigrant relatives and found that greater acculturation was associated with an increased number of causal beliefs. Further, as Western psychiatric treatment and acculturation increased, causal models expanded to incorporate biological/physical causes. However, frequency of Chinese immigrant relatives' endorsing spiritual beliefs did not appear to change with acculturation. Clinicians might thus account for spiritual beliefs in treatment even after acculturation increases and biological causal models proliferate.

Caregivers’ causal attributions of their relatives’ mental illness and the association with stigma

“…Bignall et al (2015), on the other hand, found ethnic minorities (e.g., Hispanics, Asian Americans) to consistently endorse spirituality and normalization causes as opposed to White participants; compared to 11% of Hispanics who endorsed spiritual reasons for mental illness, only 3% of Whites endorsed these. In contrast, Yang et al (2015) found no significant association between caregiver characteristics (age, gender, education), patient characteristics (marital and employment status) and causal beliefs of psychiatric illness among Chinese immigrant relatives.…”

“…In addition, increasing ''westernization''/acculturation has also been suggested as a possible reason for this pattern of endorsement. Yang et al (2015) for instance, found encounters with Western psychiatric treatment and acculturation to influence the causal beliefs of psychiatric illness endorsed by Chinese immigrant relatives. Greater acculturation was shown to be associated with a greater number of causal beliefs endorsed as well as a tendency to incorporate biological/physical causes.…”

“…While the items on the causal attributions scale were conceptually related, the scale items did not necessarily correlate with one another. As such, in accordance with Phillips et al (2000) and Yang et al (2015), reliability statistics were not calculated for this scale.…”

“…Qualitative and quantitative studies to identify the causal explanations of illness have been predominantly conducted among the public and patient populations and less so among caregivers (e.g., Arthur & Whitley, 2015; Polenick & Martire, 2013; Yang et al., 2015). Clarke and Couchman (2012), for instance, found caregivers of youths with psychosis frequently endorsed biological and substance use factors as well as psychological and stress-related factors, whereas Esterberg and Compton (2006) found family members of African Americans hospitalized with schizophrenia primarily endorsed biological causes (e.g., disturbance of brain chemistry, heredity, drug or alcohol abuse, brain infection).…”

Untitled

“…In Australia, for example, Aboriginal people are more than twice as likely to experience serious psychological distress [10]. Exposure to Western psychiatric treatment and beliefs, appears to add causal models but not to replace the original beliefs about spiritual causality [11]. As part of a larger project in how to provide culturally appropriate health care in aboriginal communities, in this paper we aimed to explore the differences in understanding and treatment of "hearing voices".…”