Overlaps and Disjunctures: A Cultural Case Study of a British Indian Young Woman’s Experiences of Bulimia Nervosa

Channa, Sunita; Lavis, Anna; Connor, Charlotte; Palmer, Colin; Leung, Newman; Birchwood, Max

doi:10.1007/s11013-019-09625-w

Cited by 9 publications

(24 citation statements)

References 80 publications

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“…Participants reported a belief that shame impacted how females used therapy or accessed treatment. The present finding from the participants complements findings by three other UK studies which also suggest that shame is a barrier for ethnic minority people accessing treatment (Channa et al 2019 ; Chowbey et al 2012 ; Wales et al 2017 ).…”

Section: Discussionsupporting

confidence: 89%

Therapists’ Experiences of Working with Ethnic Minority Females with Eating Disorders: A Qualitative Study

Kanakam

2021

Cult Med Psychiatry

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Ethnic minority females are less likely to receive a diagnosis or treatment for an eating disorder (ED). This study captured the experiences of therapists who have worked with ethnic minority females to improve outcomes for this group. Twelve therapists in the United Kingdom, London were recruited for semi-structured interviews and thematic analysis was used to analyse the data. Shame was cited as a barrier to accessing help. This influenced therapeutic work such as not challenging shame or linking this to a negative interpretation of parents. Emotional and interpersonal factors were thought to be more common risk factors for the ED. The minimising of weight and shape concern and non-fat-phobic anorexia was thought to lead to a complex and delayed route to accessing ED services. Therapists felt restricted by service management who they felt required them to deliver a narrow range of therapies that had not necessarily demonstrated therapeutic outcomes in ethnic minority females. Nevertheless, therapists reported using curiosity to guide their cultural adaptations when feeling uncertain. When working with ethnic minority females, therapists face challenges from the therapeutic and diagnostic framework that services are aligned to. Creative solutions to address this include adapting the patient care pathway, referral guides, cultural reflective practice, and the use of cultural genograms and scripts in therapeutic work to address unmet needs.

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Section: Discussionsupporting

confidence: 89%

Therapists’ Experiences of Working with Ethnic Minority Females with Eating Disorders: A Qualitative Study

Kanakam

2021

Cult Med Psychiatry

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“…Seven studies [36][37][38][39][40][41][42][43] included a mixture of young people from different non-white British ethnic minority backgrounds, and six others [30][31][32][33][34][35] had a mixture of young people from different ethnic minorities that also included some white British young people. Other studies were conducted in more specific, selected ethnic groups (black and Asian young people, 54 Orthodox Jewish young people, 50 South Asian young people, 53 Pakistani and Bangladeshi young people, 55 black British and South Asian British students, 49 and mainly Afghan refugees [45][46][47][48] ).…”

Section: Overview Of Included Studiesmentioning

confidence: 99%

“…Correspondingly, given these different service contexts and populations of interest, the age range of the young people in the study samples also varied. In six studies [31][32][33]40,41,51 the young people were all or mostly aged ≥ 18 years, and in seven studies 34,35,38,39,42,43,[45][46][47][48] they were all or mostly aged < 18 years.…”

Section: Overview Of Included Studiesmentioning

confidence: 99%

“…The nine lower-quality papers, meeting < 10 of the 13 criteria, were those by Bunting et al, 35 The Children's Society, 30 Chowbey et al, 41 Davies Hayon and Oates, 44 Fazel et al, 36,37 Gleeson et al, 54 Gray and Ralphs, 55 and King and Said. 39 The most poorly reported aspect of studies was whether or not any claims to generalisability followed logically and theoretically from the data: in the papers by Bunting et al 35 and Channa et al, 33 the claims did not appear to clearly follow the data, and in a further 17 30,34,[36][37][38][39][40][41][43][44][45][46][47]51,52,54,55 of the 26 papers there was insufficient evidence to judge this. Other quality criteria frequently not met were making explicit the theoretical or ideological perspective of the author (or funder) (not met by 15 papers 30,32,36,38,39,41,[43][44][45][46][47][48]50,51,55 ) and giving consideration to any limitations of the methods or data that may have affected the res...…”

Section: Quality Of Included Papersmentioning

confidence: 99%

“…39 The most poorly reported aspect of studies was whether or not any claims to generalisability followed logically and theoretically from the data: in the papers by Bunting et al 35 and Channa et al, 33 the claims did not appear to clearly follow the data, and in a further 17 30,34,[36][37][38][39][40][41][43][44][45][46][47]51,52,54,55 of the 26 papers there was insufficient evidence to judge this. Other quality criteria frequently not met were making explicit the theoretical or ideological perspective of the author (or funder) (not met by 15 papers 30,32,36,38,39,41,[43][44][45][46][47][48]50,51,55 ) and giving consideration to any limitations of the methods or data that may have affected the results (not met by eight papers 30,33,36,39,41,45,52,54 ). The methods of data collection were also judged not to be adequately described in nine of the papers.…”

Section: Quality Of Included Papersmentioning

confidence: 99%

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Experiences of children and young people from ethnic minorities in accessing mental health care and support: rapid scoping review

Price

Kiff

Trigg

et al. 2022

Health Soc Care Deliv Res

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Background Mental health problems are common among children and young people in the UK. Some young people from ethnic minority backgrounds experience mental health problems in different ways from those from non-ethnic minority backgrounds. Furthermore, those from ethnic minority backgrounds often experience greater difficulties in accessing mental health support and variable levels of engagement with services, and may prefer different support to their white British peers. Objective To describe the nature and scope of qualitative research about the experiences of children and young people from ethnic minority backgrounds in seeking or obtaining care or support for mental health problems. Data sources We searched seven bibliographic databases (Applied Social Sciences Index and Abstracts, Cumulative Index to Nursing and Allied Health Literature, MEDLINE, PsycInfo®, Health Management Information Consortium, Social Policy and Practice, and Web of Science) using relevant terms on 23 June 2021. Methods The scoping review included qualitative research about young people’s experiences of seeking or engaging with services or support for mental health problems. Included studies were published from 2012 onwards, were from the UK, were about those aged 10–24 years and were focused on those from ethnic minority backgrounds (i.e. not white British). Study selection, data extraction and quality assessment (with ‘Wallace’ criteria) were conducted by two reviewers. We provide a descriptive summary of the aims, scope, sample, methods and quality of the included studies, and a selected presentation of authors’ findings (i.e. no formal synthesis). Results From 5335 unique search records, we included 26 papers or reports describing 22 diverse qualitative studies. Most of the studies were well conducted and clearly described. There were studies of refugees/asylum seekers (n = 5), university students (n = 4) and studies among young people experiencing particular mental health problems (n = 14) (some studies appear in multiple categories): schizophrenia or psychosis (n = 3), eating disorders (n = 3), post-traumatic stress disorder (n = 3, in asylum seekers), substance misuse (n = 2), self-harm (n = 2) and obsessive–compulsive disorder (n = 1). There were also three studies of ethnic minority young people who were receiving particular treatments (cognitive–behavioural therapy, multisystemic therapy for families and a culturally adapted family-based talking therapy). Most studies had been conducted with young people or their parents from a range of different ethnic backgrounds. However, nine studies were conducted with particular ethnic groups: asylum seekers from Afghanistan (n = 2), and black and South Asian (n = 2), black African and black Caribbean (n = 2), South Asian (n = 1), Pakistani or Bangladeshi (n = 1) and Orthodox Jewish (n = 1) people. The studies suggested a range of factors that influence care-seeking and access to mental health care, in terms of the beliefs and knowledge of young people and their parents, the design and promotion of services, and the characteristics of care professionals. Poor access was attributed to a lack of understanding of mental health problems, lack of information about services, lack of trust in care professionals, social stigma and cultural expectations about mental resilience. Limitations As this was a rapid scoping review, there was only a basic synthesis of the research findings. Future work Future research about young people from ethnic minorities could cover a wider range of ethnic minorities, sample and analyse experiences from particular ethnic minorities separately, cover those accessing different services for different needs, and adopt multiple perspectives (e.g. service user, carer, clinician, service management). Study registration This study is registered as https://osf.io/wa7bf/. Funding This project was funded by the National Institute for Health and Care Research (NIHR) Health and Social Care Delivery programme and will be published in full in Health and Social Care Delivery; Vol. 10, No. 22. See the NIHR Journals Library website for further project information.

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The estimated burden of bulimia nervosa in the Middle East and North Africa region, 1990–2019

Safiri

Noori

Nejadghaderi

et al. 2022

Intl J Eating Disorders

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Objective We aimed to report the burden of bulimia nervosa (BN) in the Middle East and North Africa (MENA) region by age, sex, and sociodemographic index (SDI), for the period 1990–2019. Methods Estimates of the prevalence, incidence, and disability‐adjusted life‐years (DALYs) attributable to BN were retrieved from the Global Burden of Disease study 2019, between 1990 and 2019, for the 21 countries in the MENA region. The counts and age‐standardized rates (per 100,000) were presented, along with their corresponding 95% uncertainty intervals. Results In 2019, the estimated regional age‐standardized point prevalence and incidence rates of BN were 168.3 (115.0–229.6) and 178.6 (117.0–255.6) per 100,000, which represented 22.0% (17.5–27.2) and 10.4% (7.1–14.7) increases, respectively, since 1990. Moreover, in 2019 the regional age‐standardized DALY rate was 35.5 (20.6–55.5) per 100,000, which was 22.2% (16.7–28.2) higher than in 1990. In 2019, Qatar (58.6 [34.3–92.5]) and Afghanistan (18.4 [10.6–29.2]) had the highest and lowest age‐standardized DALY rates, respectively. Regionally, the age‐standardized point prevalence of BN peaked in the 30–34 age group and was more prevalent among women. In addition, there was a generally positive association between SDI and the burden of BN across the measurement period. Discussion In the MENA region, the burden of BN has increased over the last three decades. Cost‐effective preventive measures are needed in the region, especially in the high SDI countries. Public Significance This study reports the estimated burden of BN in the MENA region and shows that its burden has increased over the last three decades.

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Overlaps and Disjunctures: A Cultural Case Study of a British Indian Young Woman’s Experiences of Bulimia Nervosa

Cited by 9 publications

References 80 publications

Therapists’ Experiences of Working with Ethnic Minority Females with Eating Disorders: A Qualitative Study

Therapists’ Experiences of Working with Ethnic Minority Females with Eating Disorders: A Qualitative Study

Experiences of children and young people from ethnic minorities in accessing mental health care and support: rapid scoping review

The estimated burden of bulimia nervosa in the Middle East and North Africa region, 1990–2019

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