Qualitative Analysis of Cultural Formulation Interview: Findings and Implications for Revising the Outline for Cultural Formulation

2019 ◽  
Vol 57 (4) ◽  
pp. 525-541 ◽  
Author(s):  
Vasudeo P. Paralikar ◽  
Ankita Deshmukh ◽  
Mitchell G. Weiss
Keyword(s):  
Mental Disorders ◽  
Qualitative Analysis ◽  
Help Seeking ◽  
Common Mental Disorders ◽  
Explanatory Models ◽  
Dimensional Structure ◽  
Cultural Formulation ◽  
Dsm 5 ◽  
The Impact ◽  
Cultural Formulation Interview

The DSM-IV Outline for Cultural Formulation (OCF) was a framework for assessment based on principles of cultural psychiatry. The Cultural Formulation Interview (CFI) for DSM-5 provided a tool enabling wider use of cultural formulation in clinical cultural assessment. Validation to justify the inclusion of the CFI in DSM-5 involved quantitative analysis of debriefing interviews of patients and clinicians for feasibility, acceptability and clinical utility. We now further examine qualitative field trial data from the CFI interviews and the debriefing interviews in Pune, India. Administration of the CFI was followed by routine diagnostic assessment of 36 psychiatric outpatients—11 found to have severe mental disorders (SMD) and 25 with common mental disorders (CMD). Domain-wise thematic analyses of the CFI and debriefing interviews identified recurrent themes based on cultural identity, illness explanatory models, stressful and supportive social relationships, and the impact of political, economic, and cultural contexts. A tendency to elaborate accounts, rather than simply name their problem, and more diverse past help-seeking distinguished CMD from SMD groups. Patients valued the CFI more than clinicians did, and most patients did not consider cultural background differences of clinician-patient relationships to be relevant. Qualitative analysis of CFI data and critical analysis of domain mapping of CFI content to the structure of OCF domains indicated the value of revising the dimensional structure of the OCF. A proposed revision (OCF-R) is expected to better facilitate clinical use and research on cultural formulation and use of the CFI.

scholarly journals The Cultural Formulation Interview: Progress to date and future directions

2020 ◽  
Vol 57 (4) ◽  
pp. 487-496
Author(s):  
Roberto Lewis-Fernández ◽  
Neil Krishan Aggarwal ◽  
Laurence J. Kirmayer
Keyword(s):  
Cultural Context ◽  
Help Seeking ◽  
Scale Up ◽  
Implementation Strategies ◽  
Transcultural Psychiatry ◽  
Cultural Formulation ◽  
Treatment Expectations ◽  
Future Directions ◽  
Dsm 5 ◽  
Cultural Formulation Interview

The Cultural Formulation Interview (CFI) developed for DSM-5 provides a way to collect information on patients’ illness experience, social and cultural context, help-seeking, and treatment expectations relevant to psychiatric diagnosis and assessment. This thematic issue of Transcultural Psychiatry brings together articles examining the implementation and impact of the CFI in diverse settings. In this editorial introduction we discuss key areas raised by these and other studies, including: (1) the potential of the CFI for transforming current psychiatric assessment models; (2) training and implementation strategies for wider application and scale-up; and (3) refining the CFI by developing new modules and alternative protocols based on further research and clinical experience.

scholarly journals The Content Validity of the Cultural Formulation Interview (CFI)

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.

The development of the Short Explanatory Model Interview (SEMI) and its use among primary-care attenders with common mental disorders

1998 ◽  
Vol 28 (5) ◽  
pp. 1231-1237 ◽  
Author(s):  
K. R. LLOYD ◽  
K. S. JACOB ◽  
V. PATEL ◽  
L. St. LOUIS ◽  
D. BHUGRA ◽  
...  
Keyword(s):  
Mental Illness ◽  
Mental Disorders ◽  
Help Seeking ◽  
Common Mental Disorders ◽  
Field Work ◽  
Field Studies ◽  
Epidemiological Studies ◽  
Explanatory Models ◽  
African Caribbean ◽  
Help Seeking Behaviour

Background. Recent anthropological studies have documented the importance of understanding the relation of culture to the experience of mental illness. The use of interviews that elicit explanatory models has facilitated such research, but currently available interviews are lengthy and impractical for epidemiological studies. This paper is a preliminary report on the development of a brief instrument to elicit explanatory models for use in field work.Method. The development of the SEMI, a short interview to elicit explanatory models is described. The interview explores the subject's cultural background, nature of presenting problem, help-seeking behaviour, interaction with physician/healer and beliefs related to mental illness.Results. The SEMI was employed to study the explanatory models of subjects with common mental disorders among Whites, African-Caribbean and Asians living in London and was also used in Harare, Zimbabwe. Data from its use in four different ethnic groups is presented with the aim of demonstrating its capacity to show up differences in these varied settings.Conclusions. The simplicity and brevity of the SEMI allow for its use in field studies in different cultures, data can be used to provide variables for use in quantitative analysis and provide qualitative descriptions.

Evidence-Based Practice in School Mental Health

2019 ◽  
Keyword(s):  
Mental Health ◽  
Mental Disorders ◽  
Mental Health Problems ◽  
Common Mental Disorders ◽  
Adolescent Psychopathology ◽  
Real Life ◽  
Childhood And Adolescence ◽  
Dsm 5 ◽  
School Based ◽  
K 12

Schools have become the default mental health providers for children and adolescents, but they are often poorly equipped to meet the mental health needs of their students. The introduction tackles how to make students eligible for school-based services using the Individuals with Disabilities Education Act or Section 504 of the Rehabilitation Act. Using the new DSM-5 as an organizing principle, this book then addresses the 12 most common mental disorders of childhood and adolescence, ages 3–18. While there are many books that address child and adolescent psychopathology, this book focuses on how to help students with mental disorders in pre-K–12 schools. Each chapter addresses the prevalence of a disorder in school-age populations, appropriate diagnostic criteria, differential diagnosis, comorbid disorders, rapid assessment instruments available, school-based interventions using multitiered systems of support, and easy-to-follow suggestions for progress monitoring. Unique to this book, each chapter has detailed suggestions for how school-based clinicians can collaborate with teachers, parents, and community providers to address the needs of youth with mental health problems so that school, home, and community work together. Each chapter ends with a list of extensive web resources and a real-life case example drawn from the clinical practice of the authors. The final chapter addresses two newly proposed diagnoses for self-harm in the DSM-5 and brings a cautious and sensible approach to assessing and helping students who may be at risk for serious self-injury or suicide.

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

2020 ◽  
Vol 57 (4) ◽  
pp. 496-514 ◽  
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.

scholarly journals How Do Clinicians Prefer Cultural Competence Training? Findings from the DSM-5 Cultural Formulation Interview Field Trial

2015 ◽  
Vol 40 (4) ◽  
pp. 584-591 ◽  
Author(s):  
Neil Krishan Aggarwal ◽  
Peter Lam ◽  
Enrico G. Castillo ◽  
Mitchell G. Weiss ◽  
Esperanza Diaz ◽  
...  
Keyword(s):  
Cultural Competence ◽  
Field Trial ◽  
Cultural Formulation ◽  
Dsm 5 ◽  
Competence Training ◽  
Cultural Formulation Interview

scholarly journals Depression, Anxiety, and Stress among Rural South Indian Women—Prevalence and Correlates: A Community-Based Study

2020 ◽  
Vol 11 (01) ◽  
pp. 078-083
Author(s):  
Manikandan Srinivasan ◽  
Mahendra M. Reddy ◽  
Sonali Sarkar ◽  
Vikas Menon
Keyword(s):  
Mental Disorders ◽  
Rural Area ◽  
Rural Areas ◽  
Common Mental Disorders ◽  
Multivariable Analysis ◽  
Adult Women ◽  
Community Based ◽  
South Indian ◽  
Prevalence Of Depression ◽  
The Impact

Abstract Background The burden of common mental disorders (CMDs) which includes depression, anxiety, and stress-related disorders are on the rise in India. Women in rural areas form one of the high-risk groups with respect to CMDs due to their compromised status of living. Objective The aim of the study was to estimate the prevalence of depression, anxiety, and stress, and the predictors to depression among women in rural Puducherry. Methods A community-based, cross-sectional study was performed in 2016, among women aged 18 to 59 years, residing in the rural area of Puducherry. Prevalence of CMDs was determined using the Depression Anxiety Stress Scale (DASS)-21. Using a systematic random sampling method, women were interviewed in their houses. The socio-demographic characteristics along with risk factors for depression were captured using a semi-structured proforma. A multivariable logistic regression model was used to determine the predictors of depression. Results A total of 301 women were surveyed and their mean age (SD) was 34.9 (10.2) years. The prevalence of depression, anxiety, and stress was found to be 15% (95% CI: 11.3–19.3), 10.6% (95% CI: 7.5–14.5), and 5% (95% CI: 3–8), respectively. Multivariable analysis identified that lesser education and living separately/divorced to be significant predictors for depression in these women. Conclusion About one in six adult women living in a rural area was found to be depressed, which is considerably high. This emphasizes the need for screening among women for common mental disorders in primary care settings, especially in rural areas so that early diagnoses happen and thus reduce the impact due to mental disability.

scholarly journals The arrogance of insight?

1993 ◽  
Vol 17 (4) ◽  
pp. 233-234 ◽  
Author(s):  
Rachel Perkins ◽  
Parimala Moodley
Keyword(s):  
Health Services ◽  
Help Seeking ◽  
Mental Distress ◽  
Emotional Responses ◽  
Explanatory Models ◽  
Physical Illness ◽  
Psychological Models ◽  
Help Seeking Behaviour ◽  
The Impact ◽  
Use Of Health Services

People's beliefs about illness, distress and disability profoundly influence their experience of, and responses to, such problems. Medical anthropologists have long recognised the importance of explanatory models of physical illness and the impact of these on the provision and use of health services. Similarly, psychological models of physical illness and related behaviour stress the importance of the ways in which people conceptualise or understand their difficulties. These are central in determining emotional responses to illness, help-seeking and illness-related behaviours, attitudes towards and compliance with treatment. Eisenbruch (1990) argues that, “the culturally constructed ideas held by the patient about the cause and nature of disease” are as important in relation to mental distress and disturbance. Help-seeking behaviour, attitudes towards and compliance with treatment are of central concern in psychiatry and all of these are influenced by people's understandings of their difficulties. Yet relatively little attention has been paid to the ways in which people conceptualise their mental distress.

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