Culture in la clínica: Evaluating the utility of the Cultural Formulation Interview (CFI) in a Mexican outpatient setting

While the classification of psychiatric disorders has been critiqued for failing to adequately account for culture, the inclusion of the Cultural Formulation Interview (CFI) in the DSM-5 has been viewed as a promising development for the inclusion of cultural factors in diagnosis and treatment of mental illness. In this study, we assess the appropriateness, acceptability, and clinical utility of the CFI among outpatients in a Mexican psychiatric hospital. Our assessment included observations of psychiatric residents’ application of the CFI with 19 patients during routine outpatient visits, along with pre- and post-CFI interviews to determine providers’ and patients’ views of the CFI. The CFI was generally well received by providers and patients, viewed as a way of building trust and increasing providers’ understanding of contextual factors influencing mental illness, such as social support. However, the CFI questions specifically related to “culture” were of limited effect and both patients and providers did not view them as useful. We discuss implications for the clinical assessment of cultural factors influencing mental health and illness and for the incorporation of the CFI in Mexican clinical settings.

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Cultural Formulation Interview

Encyclopedia of Social Work ◽

10.1093/acrefore/9780199975839.013.1245 ◽

2020 ◽

Author(s):

Dorie Gilbert ◽

Katarzyna Olcoń

Keyword(s):

Mental Health ◽

Social Work ◽

Cultural Context ◽

Help Seeking ◽

Cultural Factors ◽

Cross Cultural ◽

Cultural Formulation ◽

Factors Affecting ◽

Cultural Assessment ◽

Cultural Formulation Interview

Research indicates that practitioners’ cultural biases are a barrier to effective cross-cultural assessment; thus, social work practitioners must demonstrate the ability to appraise a client’s cultural context in assessing and treating mental health concerns. The Cultural Formulation Interview (CFI) in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) provides practitioners with a standardized cultural assessment method for use in mental health practice. This article provides a comprehensive overview of the CFI with a focus on its four domains: (a) cultural definition of the problem; (b) cultural perception of cause, context, and support; (c) cultural factors affecting self-coping and past help-seeking; and (d) cultural factors affecting current help-seeking. Conceptualizations of mental health and mental illness vary across cultural subgroups, and the nation’s changing demographics underscore the need to give particular attention to how the CFI can be useful for improving cross-cultural assessment with historically excluded or marginalized racial and ethnic groups. The CFI is an important step towards culturally grounded assessments; however, it has several conceptualization and implementation limitations, including its narrow focus on individual-level cultural explanations of distress while the effects of social inequities remain masked. The article concludes with additional considerations for cross-cultural assessment and implications for social work education and practice.

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The Content Validity of the Cultural Formulation Interview (CFI)

Psychiatry Journal ◽

10.1155/2018/3082823 ◽

2018 ◽

Vol 2018 ◽

pp. 1-6

Author(s):

Behnam Shariati ◽

Amir-Abbas Keshavarz-Akhlaghi ◽

Arash Mohammadzadeh ◽

Ruohollah Seddigh

Keyword(s):

Content Validity ◽

Help Seeking ◽

The United States ◽

Cultural Factors ◽

Cultural Formulation ◽

Factors Affecting ◽

Cultural Perception ◽

Dsm 5 ◽

Back Translation ◽

Cultural Formulation Interview

Aims. The present study investigates content validity of the open-ended items in Cultural Formulation Interview in the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5). Methods. After translating into Persian and assessing the content validity of the items and their modification by psychiatrists, the questionnaire was translated back into English by two translators and then retranslated into Persian. The final Persian version and its back-translation were submitted for approval to the DSM-5 design workshop in the United States. After obtaining the group’s approval on the back-translation and permission to use the questionnaire, samples were distributed among panel members and the content validity of the questionnaire was thus examined. Results. The content validity index (CVI) of cultural formulation interview was 0.51 and all the items were acceptable although some, especially those on the cultural perception of the context and the cultural factors affecting current help-seeking, had lower content validity ratios (CVR). Conclusion. The cultural formulation interview seems to have an overall acceptable content validity although it is weak and thus needs further studies in relation to the two domains of the cultural perception of the context and the cultural factors affecting help-seeking in the Iranian population.

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The Socio-Cultural Factors on Health and Illness - A Study

International Journal for Research in Applied Science and Engineering Technology ◽

10.22214/ijraset.2021.38758 ◽

2021 ◽

Vol 9 (11) ◽

pp. 39-43

Author(s):

Dr. Vinay. K. U.

Keyword(s):

Mental Illness ◽

Patient Education ◽

Health Beliefs ◽

Medical Profession ◽

Cultural Factors ◽

Cultural Relevance ◽

Medical Professionals ◽

Medical Field ◽

Health And Illness ◽

Willingness To Use

Abstract: Our culture, not our biology, dictates which illnesses are stigmatized and which are not, which are considered disabilities and which are not, and which are deemed contestable meaning some medical professionals may find the existence of this ailment questionable as opposed to definitive illnesses that are unquestionably recognized in the medical profession in the medical field. The stigmatization of illness often has the greatest effect on the patient and the kind of care they receive. Many contend that our society and even our healthcare institutions discriminate against certain diseases like mental disorders, AIDS, venereal diseases, and skin disorders. All cultures have systems of health beliefs to explain what causes illness, how it can be cured or treated, and who should be involved in the process. The extent to which patients perceive patient education as having cultural relevance for them can have a profound effect on their reception to information provided and their willingness to use it. In Vietnamese culture, mystical beliefs explain physical and mental illness. Health is viewed as the result of a harmonious balance between the poles of hot and cold that govern bodily functions. Keywords: Life Style, Health, Education, Income, Occupation, Tradition, Beliefs. Illeness.

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Sati

Crisis ◽

10.1027/0227-5910.26.2.73 ◽

2005 ◽

Vol 26 (2) ◽

pp. 73-77 ◽

Cited By ~ 15

Author(s):

Dinesh Bhugra

Keyword(s):

Mental Illness ◽

Psychiatric Disorders ◽

Indian Subcontinent ◽

Cultural Factors ◽

Role Expectations ◽

Prevention Strategies ◽

Social Causation ◽

Gender Role Expectations ◽

Good Wife ◽

And Gender

Abstract. Sati as an act of ritual suicide has been reported from the Indian subcontinent, especially among the Hindus, for several centuries. Although legally proscribed, these acts occur even now in modern India. The principle behind such acts has been put forward as the principle of good wife. There is little evidence to suggest that women who commit this act suffer from a formal mental illness. Cultural factors and gender role expectations play a significant role in the act and its consequences. Using recent examples, this paper illustrates the cultural factors, which may be seen as contributing to the act of suicide. Other factors embedded in the act also emphasize that not all suicides have underlying psychiatric disorders and clinicians must take social causation into account while preparing any prevention strategies.

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Parental and Cultural Factors Influencing a Woman's Choice of a College Major

PsycEXTRA Dataset ◽

10.1037/e413782005-803 ◽

1999 ◽

Author(s):

Sarah Cook ◽

Manuela Hernandez

Keyword(s):

College Major ◽

Cultural Factors ◽

Factors Influencing

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Factors Influencing Stigma Toward Individuals With Mental Illness

PsycEXTRA Dataset ◽

10.1037/e701742007-001 ◽

2007 ◽

Author(s):

Karen R. Davis ◽

Susan L. McCammon ◽

Amy Lyndon ◽

Linda Mooney ◽

Caren Jordan

Keyword(s):

Mental Illness ◽

Factors Influencing

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Classification of electricity load forecasting based on the factors influencing the load consumption and methods used: An-overview

2015 IEEE Conference on Energy Conversion (CENCON) ◽

10.1109/cencon.2015.7409585 ◽

2015 ◽

Cited By ~ 10

Author(s):

M. Mustapha ◽

M. W. Mustafa ◽

S. N Khalid ◽

I. Abubakar ◽

H. Shareef

Keyword(s):

Load Forecasting ◽

Factors Influencing ◽

Electricity Load ◽

Electricity Load Forecasting

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The Cultural Formulation Interview since DSM-5: Prospects for training, research, and clinical practice

Transcultural Psychiatry ◽

10.1177/1363461520940481 ◽

2020 ◽

Vol 57 (4) ◽

pp. 496-514 ◽

Cited By ~ 1

Author(s):

Neil Krishan Aggarwal ◽

G. Eric Jarvis ◽

Ana Gómez-Carrillo ◽

Laurence J. Kirmayer ◽

Roberto Lewis-Fernández

Keyword(s):

Clinical Practice ◽

Social Science Research ◽

Science Research ◽

Cultural Dimensions ◽

Cultural Formulation ◽

Simplified Approach ◽

Clinician Training ◽

Dsm 5 ◽

Training Research ◽

Cultural Formulation Interview

While social science research has demonstrated the importance of culture in shaping psychiatric illness, clinical methods for assessing the cultural dimensions of illness have not been adopted as part of routine care. Reasons for limited integration include the impression that attention to culture requires specialized skills, is only relevant to a subset of patients from unfamiliar backgrounds, and takes too much time to be useful. The DSM-5 Cultural Formulation Interview (CFI), published in 2013, was developed to provide a simplified approach to collecting information needed for cultural assessment. It offers a 16-question interview protocol that has been field tested at sites around the world. However, little is known about how CFI implementation has affected training, health services, and clinical outcomes. This article offers a comprehensive narrative review that synthesizes peer-reviewed, published studies on CFI use. A total of 25 studies were identified, with sample sizes ranging from 1 to 460 participants. In all pilot CFI studies 960 unique subjects were enrolled, and in final CFI studies 739 were enrolled. Studies focused on how the CFI affects clinical practice; explored the CFI through research paradigms in medical communication, implementation science, and family psychiatry; and examined clinician training. In most studies, patients and clinicians reported that using the CFI improved clinical rapport. This evidence base offers an opportunity to consider implications for training, research, and clinical practice and to identify crucial areas for further research.

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Small Bowel Obstruction

AACN Advanced Critical Care ◽

10.4037/15597768-2010-2009 ◽

2010 ◽

Vol 21 (2) ◽

pp. 187-194

Author(s):

Colleen Trevino

Keyword(s):

Small Bowel ◽

Physical Examination ◽

Surgical Intervention ◽

Signs And Symptoms ◽

Bowel Ischemia ◽

Key Factors ◽

The Past ◽

Factors Influencing ◽

Imaging Response

Strategies for the management of small bowel obstructions have changed significantly over the years. Nonoperative medical management has become the mainstay of treatment of many small bowel obstructions. However, the key to the management of small bowel obstructions is identifying those patients who need surgical intervention. Identification of those at risk for bowel ischemia and bowel death is an art as much as it is a science. Using the current literature and the past knowledge regarding small bowel obstructions, the clinician must carefully identify the signs and symptoms that suggest the need for operative intervention. Classification of the obstruction, history and physical examination, imaging, response to decompression and resuscitation, and resolution or progression of symptoms are the key factors influencing the management of small bowel obstructions.

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