Expressed Emotion and Stigma among Chinese-Americans with Schizophrenia

患有精神分裂症的华裔美国人的情感表达和耻辱感

基本信息

批准号：
7190493
负责人：
LAWRENCE H YANG
金额：
$ 15.7万
依托单位：
COLUMBIA UNIVERSITY HEALTH SCIENCES
依托单位国家：
美国
项目类别：
财政年份：
2005
资助国家：
美国
起止时间：
2005-03-04 至 2010-02-28
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/7190493
关键词：
Affect American Anthropology Asian Americans Behavior Belief Chinese American Chinese People Clinical Psychology Code Communities Complex Depth Diagnostic Dimensions Discrimination Emotions Ethnic group Expressed Emotion Face Family Family member Feeling Goals Immigrant Immigration Intervention Interview Investigation K-Series Research Career Programs Knowledge Learning Linguistics Link Measurement Measures Medical Medical Research Mental Health Methods Minority Modeling Pacific Island Americans Patients Perception Population Population Heterogeneity Population Intervention Principal Investigator Process Recovery Relapse Relative (related person)Reporting Research Research Proposals Schizophrenia Shame Shapes Stigmata Structure Surgeon Training Universities Work Yang base design emotional reaction ethnic minority population experience innovation novel programs psychosocial skills social social stigma stem theories

项目摘要

DESCRIPTION (provided by applicant): The Supplement to the Surgeon General's Report on Mental Health indicates that, "It is imperative that more research be conducted on the AA/PI (Asian-American/Pacific Islander) population. Priority should be given to investigations that focus on particular AA/PI groups...(and) culturally competent forms of intervention" (p. 121-122) (1). Chinese-American patients with schizophrenia constitute a diagnostic group that suffers from a multitude of obstacles to recovery stemming from cultural, linguistic, and structural barriers. Although research has illustrated how particular emotional reactions of family members towards the patient (termed 'expressed emotion' or EE) influences patient relapse, this process has yet to be understood among any of the Asian-American ethnic groups. In addition, patients with schizophrenia and their families in the Chinese-American community experience stigma originating from Chinese cultural beliefs that may further influence illness and recovery. This study aims to investigate the extent to which factors associated with culture and immigration affect manifestations of EE among Chinese-Americans. Further, this study will explore how cultural influences in this population influence experiences of stigma. The knowledge gained from these contextual levels of analysis will ultimately be used to formulate a culturally competent family intervention for Chinese-Americans who have a family member with schizophrenia. My research proposal is divided into two distinct but related studies where we will interview a total of 50 Chinese American patients who have schizophrenia and their associated family members. The specific aims of Study 1, "EE among Chinese-American Families", are: 1) To examine how the manifestation of expressed emotion (EE) is influenced by cultural norms among Chinese-American immigrants and; 2) To examine how the distribution of EE types is influenced by cultural norms. The specific aims of Study 2. "The Impact of Culture on Stigma among Chinese-Americans with Schizophrenia", are: 1) To design a semi-structured interview to assess how culture influences the patient's experience of stigma and; 2) To pilot and validate a novel measure of stigma-related emotions (e.g., shame) experienced by Chinese-Americans with schizophrenia. The assessment of these emotions will be modeled after EE measurement. The proposed training plan will enable the applicant to study factors that will ultimately contribute to a culturally appropriate treatment of schizophrenia among an underserved ethnic minority population. The applicant's broad goals are: 1) To achieve a clear understanding of the complex familial and social factors that shape course of schizophrenia among culturally diverse populations and; 2) To develop the skills needed to implement culturally-competent family interventions for schizophrenia patients globally. The career development award would enable the applicant to receive training in: 1) standardized training to become a certified EE rater and; 2) studying medical anthropology through formal coursework and supervised research to learn qualitative theory, methods, and analysis.

描述（由申请人提供）：对外科医生的心理健康报告的补充表明，“必须对AA/PI（亚裔美国/太平洋岛民）人口进行更多研究。应优先考虑针对特定AA/PI组的调查……（和）具有文化胜任的干预形式的干预形式”（P。121-1-122）（p。121-12）（1）。精神分裂症患者的中国裔美国人构成了一个诊断组，该诊断组受到文化，语言和结构性障碍的恢复的多种障碍。尽管研究表明，家庭成员对患者（称为“表达的情绪”或EE）的特殊情感反应会影响患者的复发，但在任何亚裔美国人群体中尚未了解此过程。此外，精神分裂症的患者及其家庭中的中国裔社区中的污名来自中国文化信仰，可能会进一步影响疾病和康复。这项研究旨在调查与培养和移民相关的因素影响中国裔美国人中EE的表现的程度。此外，这项研究将探讨文化在这种人群中的影响如何影响污名的经历。从这些上下文的分析水平中获得的知识最终将用于为拥有精神分裂症家庭成员的中国美国人制定具有文化胜任的家庭干预措施。我的研究建议分为两项不同但相关的研究，我们将在其中访谈50名精神分裂症及其相关家庭成员的美国美国人患者。研究1的具体目的“中国裔美国人家庭中的EE”是：1）研究表达情感（EE）的表现如何受到中国美国移民的文化规范的影响； 2）检查如何影响EE类型的分布受文化规范的影响。研究2的具体目的。“文化对精神分裂症的中国裔美国人对污名的影响”是：1）设计半结构化访谈，以评估文化如何影响患者的污名经历和； 2）驾驶和验证一种新型的与精神分裂症的中国美国人经历的与污名相关情绪（例如，羞耻）的衡量标准。这些情绪的评估将在EE测量后建模。拟议的培训计划将使申请人能够研究最终有助于在服务不足的少数民族人口中对精神分裂症的文化治疗的因素。申请人的广泛目标是：1）清楚地了解在文化多样的人群中塑造精神分裂症的复杂家庭和社会因素以及； 2）开发为全球精神分裂症患者实施具有文化能力的家庭干预所需的技能。职业发展奖将使申请人能够接受以下培训：1）标准化培训成为经过认证的EE评估者； 2）通过正式的课程和监督研究来学习医学人类学，以学习定性理论，方法和分析。