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

• 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
• 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

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）：《卫生局局长心理健康报告补充》指出，“必须对 AA/PI（亚裔美国人/太平洋岛民）人群进行更多研究。应优先考虑调查重点关注特定的 AA/PI 群体……（和）具有文化能力的干预形式”（第 121-122 页）(1)。美国华裔精神分裂症患者构成了一个诊断群体，由于文化、语言和结构障碍，他们的康复面临着诸多障碍。尽管研究表明家庭成员对患者的特定情绪反应（称为“表达情绪”或 EE）如何影响患者复发，但亚裔美国族群尚未了解这一过程。此外，华裔社区中的精神分裂症患者及其家人还遭受来自中国文化信仰的耻辱，这可能会进一步影响疾病和康复。本研究旨在调查与文化和移民相关的因素在多大程度上影响华裔美国人的 EE 表现。此外，本研究将探讨该人群的文化影响如何影响耻辱经历。从这些背景分析中获得的知识最终将用于为有精神分裂症家庭成员的华裔美国人制定文化上有效的家庭干预措施。 我的研究计划分为两项不同但相关的研究，我们将采访总共 50 名患有精神分裂症的华裔美国患者及其相关家庭成员。研究 1“华裔美国家庭中的 EE”的具体目标是： 1）研究华裔美国移民中表达情感（EE）的表现如何受到文化规范的影响； 2) 研究文化规范如何影响EE类型的分布。研究 2“文化对华裔美国人精神分裂症患者耻辱感的影响”的具体目标是： 1）设计半结构化访谈，以评估文化如何影响患者的耻辱感体验； 2) 试点并验证一种新的测量方法，测量患有精神分裂症的华裔美国人所经历的与耻辱相关的情绪（例如羞耻）。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以文化上适当的方式治疗精神分裂症的因素。申请人的总体目标是： 1) 清楚地了解影响不同文化人群中精神分裂症病程的复杂家庭和社会因素； 2) 培养对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方面的培训：1) 成为认证 EE 评估员的标准化培训； 2）通过正规课程和监督研究学习医学人类学，以学习定性理论、方法和分析。