Mental Illness and Social Change in China

Lee, Sing; Kleinman, Arthur

doi:10.3109/10673229709034725

Cited by 23 publications

(13 citation statements)

References 9 publications

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“…As a result of rapid economic reforms and social transformations, China has witnessed rising rates of a similar constellation of mental and social health problems as the West, including mood disorders and high rates of suicide (Lee & Kleinman, 1997). However, psychotherapy is extremely limited in the country, while the disciplines of clinical psychology and psychiatric social work have barely evolved.…”

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confidence: 99%

Chinese Taoist Cognitive Psychotherapy in the Treatment of Generalized Anxiety Disorder in Contemporary China

Zhang¹,

Young

Lee

et al. 2002

Transcult Psychiatry

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Chinese Taoist cognitive psychotherapy (CTCP) combines elements of cognitive therapy and Taoist philosophy. Empirical evidence of its efficacy and mechanisms of action is lacking. This study compared the efficacy of CTCP, benzodiazepines (BDZ), and combined treatment in Chinese patients with generalized anxiety disorder (GAD). In total, 143 patients with GAD were randomly assigned to one of three treatment groups: CTCP only, BDZ only, or combined CTCP and BDZ treatment. Patients were evaluated at intake, and re-examined one and six months after treatment. The results indicated that BDZ treatment rapidly reduced symptoms of GAD at one month, but its effect was lost at six months. CTCP reduced symptoms more slowly and its effect was significant after six months of treatment. Combined treatment led to acute, as well as enduring, symptom reduction. Unlike BDZ treatment, CTCP reduced type A behavior, improved coping style, and decreased neuroticism. It is concluded that CTCP with or without BDZ treatment is a more effective, although slower, method for the treatment of GAD than BDZ for GAD patients in urban China.

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confidence: 99%

Chinese Taoist Cognitive Psychotherapy in the Treatment of Generalized Anxiety Disorder in Contemporary China

Zhang¹,

Young

Lee

et al. 2002

Transcult Psychiatry

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“…Not much work has addressed the question of whether a continuum of problematic eating may exist within one ethnically homogeneous country (over 90% of China's 1.2 billion population are ethnically Han Chinese). Inasmuch as China has experienced a rapid transformation in the recent two decades and now exhibits enormous socioeconomic heterogeneity (Lee & Kleinman, 1997;The World Bank, 1997a, 1997b, it furnishes a natural laboratory within which to examine disordered eating and social transitions. The main objective of this study was to compare disordered eating and its psychological correlates in three communities in China that lay on a gradient of economic development and societal modernization.…”

Section: Introductionmentioning

confidence: 99%

Disordered eating in three communities of China: A comparative study of female high school students in Hong Kong, Shenzhen, and rural Hunan

Lee

2000

Int. J. Eat. Disord.

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Objective To examine disordered eating and its psychological correlates among female high school students in three Chinese communities that lay on a gradient of socioeconomic development in China. Method 796 Chinese students from Hong Kong, Shenzhen, and rural Hunan completed a demographic and weight data sheet, the Eating Attitudes Test (EAT‐26), a Body Dissatisfaction Scale (BDS), the Beck Depression Inventory (BDI), and the Rosenberg Self‐Esteem Scale (RSES). Results Compared to students in Hunan and to a lesser extent students in Shenzhen, students from Hong Kong were slimmer, but desired a lower body mass index (BMI), reported more body dissatisfaction, exhibited a more typical EAT‐26 factor structure, scored higher on the “fat concern and dieting” factor, and constituted more EAT‐26 high scorers. Multiple regression analyses indicated that BDS was the most significant predictor of fat concern at each site, but this effect was strongest in Hong Kong. Hunan students had significantly higher BDI scores but lower fat concern than Shenzhen and Hong Kong students. Discussion The consistent gradient of fat concern across the three communities gives credence to the view that societal modernization fosters disordered eating in women, possibly via the gendered social constraints that accompany it. It is also expressive of the marked socioeconomic heterogeneity within China nowadays. The predictable rising rate of eating disorders that follows global change will pose a growing public health challenge to Asian countries. © 2000 by John Wiley & Sons, Inc. Int J Eat Disord 27: 317–327, 2000.

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“…We used our findings to iteratively and collaboratively co-develop an indigenous instrument for assessing depression as experienced by the Luo. We use this instrument -as well as a standard instrument -to investigate the degree of overlap between the indigenous instrument and a standard Western instrument, as has been done in previous similar cross-cultural undertakings (Lee & Kleinman, 1997;Manson et al, 1985) as well as in studies with refugees from low-and middle-income countries who have emigrated to the West (Kokanovic, Dowrick, Butler, Herrman, & Gunn, 2008). With a community sample, we also identify the correlation between depressive symptoms, as measured by both instruments, with anxiety and sociodemographic variables.…”

Section: Complementing Standard Western Measures Of Depression With Lmentioning

confidence: 99%

Complementing Standard Western Measures of Depression with Locally Co-developed Instruments: A Cross-Cultural Study on the Experience of Depression Among the Luo in Kenya

Osborn¹,

Kleinman²,

Weisz³

2020

Preprint

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Our present understanding of depression relies on a Western nosology that might not be generalizable across diverse cultures around the world. As a consequence, current clinical research and practice may not capture culturally salient features of depression. Expanded cross-cultural research that uses ethnographic methods and indigenous instruments may yield information of clinical utility to enhance culturally sensitive research and practice. In this mixed methods study, we used ethno-semantic interview procedures based on the DSM-5’s cultural formulation process to elicit a broad range of depression features reported by the Luo people of Western Kenya. We identified how the Luo conceptualize depression, including idioms of depressive distress, moods associated with persistent negative affect, and other features including context, stressors and support systems. This information informed the co-development of a Luo Depression Questionnaire (LDQ-17). We used the LDQ-17 in a cross-sectional community survey (N=116) to investigate its association with a standard Western instrument (Patient Health Questionnaire-9; PHQ-9). Factor analysis revealed a 1-factor model for the PHQ-9 but not the LDQ-17 for which exploratory factor analysis suggested a 3-factor model including cognitive, affective, and physical symptoms. Psychological, environmental/social, and even supernatural causes of these symptoms were identified, as were support systems. Finally, visualizations through multidimensional scaling approaches showed some overlap between the LDQ-17 and the PHQ-9, but the indigenous LDQ-17 identified salient features the Luo associated with depression that the PHQ-9 missed. Our findings illustrate how simple ethnographic procedures may guide development of indigenous instruments to complement current standardized instruments, potentially enhancing cultural relevance.

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Mental Illness and Social Change in China

Cited by 23 publications

References 9 publications

Chinese Taoist Cognitive Psychotherapy in the Treatment of Generalized Anxiety Disorder in Contemporary China

Chinese Taoist Cognitive Psychotherapy in the Treatment of Generalized Anxiety Disorder in Contemporary China

Disordered eating in three communities of China: A comparative study of female high school students in Hong Kong, Shenzhen, and rural Hunan

Complementing Standard Western Measures of Depression with Locally Co-developed Instruments: A Cross-Cultural Study on the Experience of Depression Among the Luo in Kenya

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