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Exploring Perceptions of “Wellness” in Black Ethnic Minority Individuals at Risk of Developing Psychosis

  • Louisa Codjoe (a1), Majella Byrne (a1), Matthew Lister (a2), Philip McGuire (a3) and Lucia Valmaggia (a4)...

Abstract

Background: The NICE Schizophrenia guidelines (NICE, 2009, Update) recommend that services should address cultural differences in treatment, expectations and adherence, and clients’ explanatory models of illness should be better understood. Service users from Black African and Black Caribbean communities are overrepresented in psychosis services in the UK, yet there is no literature on how wellness is understood by this group. Aims: This study explored perceptions of wellness in Black African and Black Caribbean individuals with an At Risk Mental State (ARMS) for psychosis. Method: A Q set of potential meanings of wellness was identified from a literature search and interviews with people at risk of developing psychosis. From this, 50 potential definitions were identified; twenty Black African and Black Caribbean ARMS clients ranked these definitions. Results: Following factor analysis of completed Q sorts, six factors emerged that offered insight into perceptions of wellness in this population. These factors included: sense of social purpose explanation, the surviving God's test explanation, the internalization of spirituality explanation, understanding and attribution of symptoms to witchcraft explanation, avoidance and adversity explanation, and seeking help to cope explanation. Conclusions: Although preliminary, differences between the factors suggests that there may be perceptions of wellness specific to these groups that are distinct from the medical view of wellness promoted within early detection services. These differences may potentially impact upon engagement, particularly factors that clients feel may facilitate or aide their recovery. It is suggested that these differences need to be considered as part of the assessment and formulation process.

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Corresponding author

Reprint requests to Louisa Codjoe, Institute of Psychiatry, Psychosis Studies, PO Box 63, de Crespigny Park, Denmark Hill, London SE5 8AF, UK. E-mail: louisa.codjoe@slam.nhs.uk

References

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Adams, T., Bezner, J. and Steinhardt, M. (1997). The conceptualization and measurement of perceived wellness: integrating balance across and within dimensions. American Journal of Health Promotion, 11, 208218.
Aldrich, S. and Eccleston, C. (2000). Making sense of everyday pain. Social Science and Medicine, 50, 16311641.
Becker, M. H. and Maimon, L. A. (1983). Models of health related behaviour. In Mechanic, D. (Ed.), Handbook of Health, Health Care and the Health Professions (pp. 539568). New York: Free Press.
Berry, K. K. L., Wearden, A. J. and Barrowclough, C. (2007). Adult attachment styles and psychosis: an investigation of associations between general attachment styles and attachment relationships with specific others. Social Psychiatry and Psychiatric Epidemiology, 42, 972976.
Broome, M. R., Woolley, J. B., Johns, L. C., Valmaggia, L. R., Tabraham, P., Gafoor, R., et al. (2005). Outreach and support in south London (OASIS): implementation of a clinical service for prodromal psychosis and the at risk mental state. European Psychiatry, 20, 372378.
Cantor-Graee, E. and Selten, , , J-P. (2005). Schizophrenia and migration: a meta-analysis and review. American Journal of Psychiatry, 162, 1224.
Cantor-Graee, E. and Pedersen, C. B. (2007). Risk of schizophrenia in second-generation immigrants: a Danish population-based cohort study. Psychological Medicine, 37, 485494.
Collins English Dictionary (2012). Complete and Unabridged 10th Edition. Retrieved 14 May, 2012 from Dictionary.com: http://dictionary.reference.com/browse/culture.
Diener, E., Diener, M. and Diener, C. (2009). Factors Predicting the Subjective Well-being of Nations. Social Indicators Research Series. Netherlands: Springer.
Diener, E. and Lucas, R. E. (2000). Subjective emotional well-being. In Lewis, M. and Haviland, J. M. (Eds.), Handbook of Emotions (2nd ed.) (pp. 325337). New York: Guilford.
Dudley, R., Siitarinen, J., James, I. and Dodgson, G. (2009). What do people with psychosis think caused their psychosis? A Q methodology study. Behavioural and Cognitive Psychotherapy, 37, 1124.
Fallot, R. D. (2001). Spirituality and religion in psychiatric rehabilitation and recovery from mental illness. International Review of Psychiatry, 13, 110116.
Fearon, P. and Morgan, C. (2006). Environmental factors in schizophrenia: the role of migrant studies. Schizophrenia Bulletin, 32, 405408.
Garety, P. A., Kuipers, E. and Fowler, D. (2001). A cognitive model of the positive symptoms of psychosis. Psychological Medicine, 31, 189195.
Gumley, A. and Schwannauer, M. (2006). Staying Well After Psychosis: a cognitive interpersonal approach to recovery and relapse prevention. Chichester: Wiley and Sons Ltd.
Henquet, C., Krabbendam, L., Spauwen, J., Kaplan, C., Lieb, R., Wittchen, H. U., et al. (2005). Prospective cohort study of cannabis use, predisposition for psychosis, and psychotic symptoms in young people. British Medical Journal, 330 (7481), 11.
Jones, S. T., Guy, A. and Ormrod, J. A. (2003). A Q-methodological study of hearing voices: a preliminary exploration of voice hearers’ understanding of their experiences. Psychology and Psychotherapy: Theory Research and Practice, 76, 189209.
Kessler, R. C., McGonagle, K. A. and Zhao, S. (1994). Lifetime and 12-month prevalence of DSMIII-R psychiatric disorders in the United States. Results from the National Comorbidity Survey. Archives of General Psychiatry, 51, 819.
Kinderman, P., Setzu, E., Lobban, F. and Salmon, P. (2006). Illness beliefs in schizophrenia. Social Science and Medicine, 63, 19001911.
Kitzinger, C. (1987). The Social Construction of Lesbianism (Inquiries in Social Construction series). London: Sage Publications.
Koenig, H. G. (2007). Religion and remission of depression in medical inpatients with heart failure/pulmonary disease. Journal of Nervous and Mental Disease, 195, 389395.
Lloyd, P. and Moodley, P. (1992). Psychotropic medication and ethnicity: an inpatient survey. Social Psychiatry and Psychiatric Epidemiology, 27, 95101.
Lysaker, P. H. (2003). Movement towards coherence in the psychotherapy of schizophrenia: a method for assessing narrative transformation. The Journal of Nervous and Mental Disease, 191, 538541.
Mallett, R., Leff, J. and Bhugra, D. (2004). Social environment, ethnicity and schizophrenia: a case-control study. Social Psychiatry Epidemiology, 37, 329335.
Markus, H. R. and Kitayama, S. (1991). Culture and the self: implications for cognition, emotion, and motivation. Psychological Review, 98, 224253.
McCabe, R. and Priebe, S. (2004). Explanatory models of illness in schizophrenia: a comparison of four ethnic groups. British Journal of Psychiatry, 185, 2530.
Mental Health Act Commission (1999). Eighth Biennial Report. London: The Stationery Office.
Morgan, C., Mallett, R. and Hutchinson, G. (2005). Pathways to care and ethnicity. 2. Source of referral and help-seeking. Report from the AESOP study. British Journal of Psychiatry, 186, 290296.
Morrison, A. P., French, P., Parker, S., Roberts, W., Stevens, H., Bentall, R. P., et al. (2005). Three-year follow-up of a randomized controlled trial of cognitive therapy for the prevention of psychosis in people at ultra high risk. Schizophrenia Bulletin, 33, 682687.
National Institute for Health and Clinical Excellence, Update (NICE) (2009). Schizophrenia: core interventions in the treatment and management of schizophrenia in primary and secondary care. Ref: CG82. http://www.nice.org.uk/CG001.
Office of National Statistics (2011). Ref: http://www.statistics.gov.uk/census2001/profiles/00be.asp.
Parish, J. (2005). From Liverpool to Freetown: West African witchcraft, conspiracy and the occult. Culture and Religion, 6, 353368.
Rathod, S., Kingdon, D., Phiri, P. and Gobbi, M. (2010). Developing culturally sensitive cognitive behaviour therapy for psychosis for ethnic minority patients by exploration and incorporation of service users’ and health professionals’ views and opinions. Behavioural and Cognitive Psychotherapy, 38, 511533.
Reger, G. M. and Rogers, S. A. (2002). Diagnostic differences in religious coping among individuals with persistent mental illness. Journal of Psychology and Christianity, 21, 341348.
Ryff, C. D. and Keyes, C. L. M. (1995). The structure of psychological well-being revisited. Journal of Personality and Social Psychology, 69, 719727.
Sainsbury Centre for Mental Health (2002). Breaking the Circles of Fear: a review of the relationship between mental health services and African and Caribbean communities. London: Sainsbury Centre for Mental Health.
Schmolck, P. (2002). PQMethod (Version 2.11). Adapted from mainframe-program Qmethod written by John Atkinson, 1992) [Computer Software]. Neubiberg, University of the Bundeswehr, Munich. Available as freeware at://www.rz.unibwmuenchen.de/~p41bsmk/qmethod/.
Selten, J. P., Veen, N., Feller, W., Blom, J. D., Schols, D., Camoenië, W., et al. (2001). Incidence of psychotic disorders in immigrant groups to the Netherlands. British Journal of Psychiatry, 178, 367372.
Sharpley, M. S., Hutchinson, G. and Murray, R. M. (2001). Understanding the excess of psychosis among the African Caribbean population in England: review of current hypotheses. British Journal of Psychiatry, 178, s6068.
Shinebourne, P. and Adams, M. (2009). Therapists’ understandings and experiences of working with clients with problems of addiction: a pilot study using Q methodology. Counselling and Psychotherapy Research, 7, 211219.
Stenner, P. and Marshall, H. (1995). A Q methodological study of rebelliousness. European Journal of Social Psychology, 25, 621636.
Stainton Rogers, R. (1995) Q methodology. In Smith, J. A., Harre, R. and Longenhove, I. Van (Eds.), Rethinking Methods in Psychology (pp. 178193). London: Sage.
Summerfield, S. and Veale, D. (2008). Proposals for massive expansion of psychological therapies would be counterproductive across society. The British Journal of Psychiatry, 192, 326330.
Tepper, L., Rogers, S. A. and Coleman, E. M. (2001). The prevalence of religious coping among persons with persistent mental illness. Psychiatric Services, 52, 660665.
Triandis, H. C. (2000). Cultural syndromes and subjective well-being. In Diener, E. and Suh, E. M. (Eds.), Subjective Well-Being Across Cultures (pp. 1337). Cambridge, MA: MIT Press.
Veenhoven, R. (2007). Measures of Gross National Happiness. Paper presented at OECD conference on Measurability and Policy Relevance of Happiness, 2–3 April, Rome. http://www.oecd.org/document/12/0,2340,en_21571361_31938349_37720396_1-1_1_1,00.html. Accessed January 2010.
Veling, W., Selten, J-P., Veen, N., Laan, W., Blom, J. D. and Hoek, H. W. (2006). Incidence of schizophrenia among ethnic minorities in the Netherlands: a four-year first-contact study. Schizophrenia Research, 86, 189193.
Warner, R. (2009). Recovery from schizophrenia and the recovery model. Current Opinion in Psychiatry, 22, 374380.
Watts, S. and Stenner, P. (2005). Doing Q methodology: theory, method and interpretation. Qualitative Research in Psychology, 2, 6791.
Yung, A. R., Yuen, H. P., McGorry, P. D., Phillips, L. J., Kelly, D., Dell'Olio, M., et al. (2005). Mapping the onset of psychosis: the comprehensive assessment of at-risk mental states. Australian and New Zealand Journal of Psychiatry, 39, 964971.
Ziguras, S., Klimidis, S., Lewis, J. and Stuart, G. (2003). Ethnic matching of clients and clinicians and use of mental health services by ethnic minority clients. Psychiatric Services, 54, 535541.
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Behavioural and Cognitive Psychotherapy
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Exploring Perceptions of “Wellness” in Black Ethnic Minority Individuals at Risk of Developing Psychosis

  • Louisa Codjoe (a1), Majella Byrne (a1), Matthew Lister (a2), Philip McGuire (a3) and Lucia Valmaggia (a4)...
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