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For more than three decades the author has been concerned with issues to do with emotion, suffering and healing. This volume presents ethnographic studies of South Wales, Maharashtra and post-Soviet Latvia connected by a theoretical interest in healing, emotion and subjectivity. Exploring the uses of narrative in the shaping of memory, autobiography and illness and its connections with the master narratives of history and culture, it focuses on the post-Soviet clinic as an arena in which the contradictions of a liberal economy are translated into a medical language.

Objectives. We used the Stigma in Global Context–Mental Health Study to assess the core sentiments that represent consistent, salient public health intervention targets. Methods. Data from 16 countries employed a nationally representative sampling strategy, international collaboration for instrument development, and case vignettes with Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition depression and schizophrenia criteria. We measured knowledge and prejudice with existing questions and scales, and employed exploratory data analysis to examine the public response to 43 items. Results. Across countries, levels of recognition, acceptance of neurobiological attributions, and treatment endorsement were high. However, a core of 5 prejudice items was consistently high, even in countries with low overall stigma levels. The levels were generally lower for depression than schizophrenia, and exclusionary sentiments for more intimate venues and in authority-based roles showed the greatest stigma. Negative responses to schizophrenia and depression were highly correlated across countries. Conclusions. These results challenge researchers to reconfigure measurement strategies and policymakers to reconsider efforts to improve population mental health. Efforts should prioritize inclusion, integration, and competences for the reduction of cultural barriers to recognition, response, and recovery.

Background Suicide attempts are critical predictors of suicide. Developing typologies of suicide attempt may indicate new prevention strategies, which have not been investigated by comparing developed and developing countries. Therefore, we aimed to explore the subtypes of suicide attempt and to compare the characteristics of these subtypes between developed and developing countries. Methods This study included 2046 British and 4238 Chinese men aged 18 − 34 years old in households. Hierarchical multinomial regression models were performed to investigate associated factors of suicide attempt. Latent class analysis was employed to identify subtypes of suicide attempt. Results We found that anxiety and psychosis were independently associated with suicide attempts among British and Chinese young men, while depression was independently associated with suicide attempts only among British young men. Three latent classes of suicide attempt were identified: depressed/anxious subtype was robust across the Eastern and Western cultural contexts; no psychiatric morbidity subtype featured by weakened social bonds was significant more prevalent among Chinese young men attempted suicide, whereas impulsive, trauma, psychopathology subtype was significant more prevalent among British men attempted suicide. Conclusions These differences of attempted suicide appeared to result from the distinct social factors in China and the UK. Weakened social bonds could be a new intervention target for Chinese young men attempted suicide, whereas chaotic lifestyles for that of British young men attempted suicide.

Help-seeking behavior for mental health issues among university students is shaped by cultural norms, stigma, and digital engagement. In many African contexts, cultural perceptions of mental illness remain highly stigmatized, posing barriers to seeking support. This study examined the mediating role of mental health stigma and the moderating effect of digital engagement in the relationship between cultural norms and help-seeking behavior among Ghanaian university students. A cross-sectional quantitative design using Structural Equation Modeling (SEM) was employed, with data from 1,067 students across five traditional public universities. Findings revealed that cultural norms significantly increased mental health stigma (β = 0.420, p  < .001), which in turn reduced help-seeking behavior (β = -0.370, p  < .001). A direct negative effect of cultural norms on help-seeking behavior was also observed (β = -0.210, p  < .001). The indirect effect through stigma was significant (β = -0.155, p  < .001), confirming the mediating role of stigma. Digital engagement moderated both the direct and indirect relationships. Specifically, it weakened the negative impact of stigma on help-seeking (β = 0.125, p  = .002) and buffered the effect of cultural norms (β = 0.098, p  = .005). Moderated mediation analysis further showed that digital engagement acted as a protective factor: stronger mediation was observed at lower levels of digital engagement (β = -0.198, p  < .001) and weaker mediation at higher levels (β = -0.082, p  < .001). These findings underscore the complex interplay of cultural and technological factors in mental health behaviors. The study highlights the need for culturally responsive mental health interventions and supports the integration of digital tools to reduce stigma and enhance help-seeking among university students.

Objective This study aimed to develop a culturally adapted Chinese version of the Value-based Stigma Inventory (VASI) and to evaluate its psychometric properties, including reliability and validity, among the general Chinese population. Methods This study is a cross-sectional study. Convenience sampling was used to recruit 708 general citizens from Shenyang City, Liaoning Province, China. The VASI’s internal consistency, split-half reliability, and test–retest reliability were tested to assess the translated scale’s reliability. Several validity tests were performed, including expert consultation, exploratory factor analysis, and confirmatory factor analysis. Data were analyzed using SPSS 25.0 (IBM Corp., Armonk, NY, United States) and AMOS 23.0 (IBM Corp., Armonk, NY, United States). Results The Chinese version of the VASI showed good reliability, with a Cronbach’s α value of 0.808, and the dimensions ranged from 0.812 to 0.850. Test–retest reliability showed good temporal stability with a value of 0.855, and the split-half reliability value was 0.845, indicating a high degree of consistency. The scale also demonstrated good content validity with a content validity index of 0.952. After conducting exploratory factor analysis, a five-factor structure was identified, including factors of self-realization, personal enrichment, reputation, meritocratic values, and security. In the confirmatory factor analysis, all recommended fit indicators were found to be within the acceptable range, including χ 2 /DF = 1.338, GFI = 0.960, AGFI = 0.940, RMSEA = 0.031, TLI = 0.985, CFI = 0.989, IFI = 0.989, PGFI = 0.640, and PNFI = 0.729. Conclusion The Chinese version of the VASI is valid and reliable among the Chinese general public. The five-factor structured scale effectively assessed public stigma against mental illness, including the value orientations associated with personal stigma. Given the harsh and widespread public stigma against mental illness, the findings from the questionnaire may inform the development of future public health education programs. Public health education is needed to reduce the stigma of mental illness, increase public awareness of mental health issues, and mitigate the continued stigmatization of mental illness.

Background Despite grief being a universal experience, current understanding of the trajectory and predictive factors of the new condition, Prolonged Grief Disorder (PGD), mostly arises from studies conducted in Europe and North America. Research suggests cultural variations in how grief develops across time. This study aims to longitudinally compare PGD growth patterns across Swiss, Vietnamese, and Rwandan bereaved individuals. Methods Due to grief’s wave-like nature, experience sampling methods (ESM) enables a fine-grained temporal analysis of grief manifestation. A total of 100 bereaved individuals from each country who lost a loved one in the last 3 years will complete a 2-week ESM assessment app (mPath) every 3 months for 6 months (Viet Nam and Rwanda) or 18 months (Switzerland). The app sends daily reminders to complete a questionnaire about PGD symptoms and daily life context. Participants will also complete a baseline mental health assessment before each ESM period. The primary outcomes are symptom variability and chronicity, while secondary outcomes include culturally specific predictive factors of prolonged grief symptoms (e.g., mourning rituals). Acceptability and feasibility of daily assessment will also be assessed. The method and specific ESM items have been developed and tested through cognitive interviews with bereaved individuals from each cultural group to ensure cultural acceptability. Discussion The current study is the first to longitudinally explore potential cultural variations in grief trajectories across Swiss, Vietnamese, and Rwandan bereaved individuals. This study has significant potential to contribute to more nuanced, culturally informed, and technologically integrated approaches to bereavement care.

To develop a comprehensive understanding of caregiver burden and its predictors from a dyadic perspective. A convergent mixed methods design was used. This study was conducted in three European countries, Italy, Spain, and the Netherlands. A sample of 229 HF patients and caregivers was enrolled between February 2017 and December 2018 from the internal medicine ward, outpatient clinic, and private cardiologist medical office. In total, 184 dyads completed validated scales to measure burden, and 50 caregivers participated in semi-structured interviews to better understand the caregiver experience. The Care Dependency Scale, Montreal Cognitive Assessment, and SF-8 Health Survey were used for data collection. Multiple regression analysis was conducted to identify the predictors and qualitative content analysis was performed on qualitative data. The results were merged using joint displays. Caregiver burden was predicted by the patient's worse cognitive impairment, lower physical quality of life, and a higher care dependency perceived by the caregivers. The qualitative and mixed analysis demonstrated that caregiver burden has a physical, emotional, and social nature. Caregiver burden can affect the capability of informal caregivers to support and care for their relatives with heart failure. Developing and evaluating individual and community-based strategies to address caregiver burden and enhance their quality of life are warranted.

Americans' perceptions of childhood disability have changed dramatically over the past century, as have their ideas about health and illness, medical developments, threats to children's health and development, and expectations for child functioning. Neal Halfon, Amy Houtrow, Kandyce Larson, and Paul Newacheck examine how these changes have influenced the risk of poor health and disability and how recent policies to address the needs of children with disabilities have evolved. The authors examine the prevalence in the United States of childhood disability and of the conditions responsible for impairment, as well as trends in the prevalence of chronic conditions associated with disability. They find that childhood disability is increasing and that emotional, behavioral, and neurological disabilities are now more prevalent than physical impairments. They stress the importance of, and lack of progress in, improving socioeconomic disparities in disability prevalence, as well as the need for better measures and greater harmonization of data and data sources across different child-serving agencies and levels of government. They call on policy makers to strengthen existing data systems to advance understanding of the causes of childhood disabilities and guide the formulation of more strategic, responsive, and effective policies, programs, and interventions. The authors offer a new and forward-looking definition of childhood disability that reflects emerging and developmentally responsive notions of childhood health and disability. They highlight the relationship between health, functioning, and the environment; the gap in function between a child's abilities and the norm; and how that gap limits the child's ability to engage successfully with his or her world. Their definition also recognizes the dynamic nature of disability and how the experience of disability can be modified by the child's environment.

This article first documents evidence on the changing prevalence of childhood physical and mental health problems, focusing on the development of childhood health conditions in the United States. Authors Liam Delaney and James Smith present evidence on the changing prevalence of childhood chronic conditions over time using recalled data as well as contemporaneous accounts of these childhood health problems. The raw data from both sources show sharp increases in the prevalence of most childhood physical health problems (such as asthma, allergies, respiratory problems, and migraines) over time. However, inferring trends is difficult because such data are also consistent with improved detection of childhood disease, and many of the causes of childhood disease have not worsened over time. Conclusions about rapidly rising rates of childhood physical health problems over time are premature at best, especially concerning the magnitude of trends. Documenting real changes in the prevalence of specific diseases is a high-priority research topic. In contrast, the evidence is much stronger that childhood mental health problems are becoming worse. The authors next present new evidence on the effects of early childhood physical and mental problems on health and economic status in adulthood. They find that both childhood physical and mental health problems contribute significantly to poorer adult health. However, they also find that childhood mental health problems have much larger impacts than do childhood physical health problems on four critical areas of socioeconomic status as an adult: education, weeks worked per year, individual earnings, and family income. Finally, the authors examine evidence regarding the efficacy of early mental health treatment for children in terms of promoting good health later on. Existing studies suggest that a combination of cognitive behavioral therapy and medication appears to be effective in the treatment of both anxiety and depression in children. However, much more research is needed on the efficacy of these childhood interventions into adulthood. Clinical trials have been too short to evaluate the long-term impacts of various forms of treatment, and these impacts are definitively long term.

The Women's Experience with Battering (WEB) scale is a self-report instrument that uses a 10-item Likert-type scale to measure IPV victims' cognitive and affective experience of battering. This study aimed to validate the Chinese version of the WEB scale using gender-neutral questions, Experience of Battering Scale (Chinese) (EBS-C), to assess the psychological vulnerability of victims of intimate partner violence (IPV). The study adopted a range of methods, including translation and back translation, expert reviews, cognitive debriefing, and test-retest reliability assessment. The EBS-C was validated in a purposive convenience sample of 718 Chinese-speaking participants (male = 362; female = 356) aged 18-24 (mean age = 21.4) in Hong Kong. The results of CFA showed a good model fit: CFI = .97, TLI = .96, RMSEA = .05, SRMR = .03. The EBS-C was also found to be significantly associated with the Revised Conflict Tactics Scales (CTS2; r = .13-.17, p < .01), depression (BDI-II: r = .15, p < .01), anxiety (GAD-7: r = .17, p < .01), interpersonal support (ISEL-12: r = -.27, p < .01), relationship satisfaction (RAS: r = -.36, p < .01), and self-esteem (RSES: r = -.22, p < .01). The study demonstrated the EBS-C to be a reliable and valid measure for assessing the psychological vulnerability of IPV victims. It is thus useful for identifying the risks such individuals face by assessing their experience of fear, danger, and disempowerment in the intimate relationship relative to abusive incident-based measures alone. The EBS-C will also be useful for developing effective treatments to address the psychological vulnerability resulting from IPV and will facilitate cross-cultural comparative research aimed at enriching our knowledge of IPV victimization.