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Psychiatric diagnostic manuals recognise the importance of local expressions of distress in culturally diverse settings [i.e. idioms/cultural concepts of distress (CCDs)], yet there is a lack of consensus on how these should be incorporated into mental health related research.
Aims.
To perform a narrative synthesis and critical review of research exploring how idioms/CCDs have been integrated into assessment measures and interventions.
Method.
A systematic review was conducted in accordance with PRISMA guidelines. An adapted version of the COSMIN checklist was used to assess the quality of the linguistic translation of the idioms/CCDs.
Results.
Twenty-nine papers were included in the final review. Primary qualitative research was the most common method of gathering information about idioms/CCDs. The majority of studies described integrating idioms/CCDs into assessment measures as opposed to interventions. Some studies used information relating to idioms/CCDs to develop novel assessment measures, while others adapted pre-existing assessment measures. The measures generated moderate to high levels of validity. Information relating to the linguistic translation conducted in the completion of the studies tended to be inadequately reported.
Conclusions.
Integrating information about idioms/CCDs into assessment measures can enhance the validity of these assessments. Allocating greater research attention to idioms/CCDs can also promote more equitable exchanges of knowledge about mental health and wellbeing between the Global North and the Global South.
This chapter describes the clinical relevance of idioms of distress for the generation and treatment of anxiety disorders, focusing mainly on those related to panic disorder and post-traumatic stress disorder (PTSD) in Southeast Asian and Latino populations. It reviews idioms of distress that are cultural illness syndromes. Certain idioms of distress may indicate impairment in psychosocial functioning, including work and social functioning, as well as general well-being, as assessed by quality-of-life and disability measures. The chapter also presents a model of how anxiety disorders and idioms of distress mutually reinforce each other, forming interacting escalating loops that link expectation, attention, catastrophic cognitions, and activation of the autonomic nervous system. Awareness of the relationship between cultural syndromes and anxiety disorders can enhance clinicians' ability to engage patients about a variety of therapeutic approaches and to tailor evidence-based treatments to patients' cultural understandings and experiences.
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