Illness causal beliefs in Turkish immigrants

<p>Abstract</p> <p>Background</p> <p>People hold a wide variety of beliefs concerning the causes of illness. Such beliefs vary across cultures and, among immigrants, may be influenced by many factors, including level of acculturation, gender, level of education, and experience of illness and treatment. This study examines illness causal beliefs in Turkish-immigrants in Australia.</p> <p>Methods</p> <p>Causal beliefs about somatic and mental illness were examined in a sample of 444 members of the Turkish population of Melbourne. The socio-demographic characteristics of the sample were broadly similar to those of the Melbourne Turkish community. Five issues were examined: the structure of causal beliefs; the relative frequency of natural, supernatural and metaphysical beliefs; ascription of somatic, mental, or both somatic and mental conditions to the various causes; the correlations of belief types with socio-demographic, modernizing and acculturation variables; and the relationship between causal beliefs and current illness.</p> <p>Results</p> <p>Principal components analysis revealed two broad factors, accounting for 58 percent of the variation in scores on illness belief scales, distinctly interpretable as natural and supernatural beliefs. Second, beliefs in natural causes were more frequent than beliefs in supernatural causes. Third, some causal beliefs were commonly linked to both somatic and mental conditions while others were regarded as more specific to either somatic or mental disorders. Last, there was a range of correlations between endorsement of belief types and factors defining heterogeneity within the community, including with demographic factors, indicators of modernizing and acculturative processes, and the current presence of illness.</p> <p>Conclusion</p> <p>Results supported the classification of causal beliefs proposed by Murdock, Wilson & Frederick, with a division into natural and supernatural causes. While belief in natural causes is more common, belief in supernatural causes persists despite modernizing and acculturative influences. Different types of causal beliefs are held in relation to somatic or mental illness, and a variety of apparently logically incompatible beliefs may be concurrently held. Illness causal beliefs are dynamic and are related to demographic, modernizing, and acculturative factors, and to the current presence of illness. Any assumption of uniformity of illness causal beliefs within a community, even one that is relatively culturally homogeneous, is likely to be misleading. A better understanding of the diversity, and determinants, of illness causal beliefs can be of value in improving our understanding of illness experience, the clinical process, and in developing more effective health services and population health strategies.</p

Mentalizing and substance use disorder

In this chapter we will describe how Mentalization-Based Treatment for Substance Use Disorder (MBT-SUD) can be implemented for substance use disorder (SUD), why this model and its theoretical foundation make sense, and how it broadens our understanding of SUD patients with severe personality disorders (PDs) (Morken, Karterud and Arefjord 2014; Morken et al. 2017a; Morken, Binder, Arefjord and Karterud 2017b). In modern SUD treatment it remains a challenge to offer effective outpatient treatment for patients with SUD and severe PDs. Outpatient programs need to be comprehensive and intensive, and treatment must be effective in terms of reducing the use of inpatient crisis admittance. Patients with comorbid PD/SUD often show problems with regular attendance in outpatient programs. This is due not only to the SUD and the patients’ varying motivation and lack of endurance, but also to their difficulties in coping with their feelings and interpersonal problems. SUD therapists are in need of useful tools to be able to offer effective outpatient treatment to these patients. There is a need for therapy programs with a good structure, theoretical consistency, and continuity