Department of Health Promotion and Development, University of Bergen, Christiesgate 13, Bergen, Norway.
Transcult Psychiatry. 2012 Jul;49(3-4):461-91. doi: 10.1177/1363461512448325.
This article reviews the expanding body of literature that examines the mental health of HIV-affected children in sub-Saharan Africa. Focusing on primary research across disciplines and methodologies, the review examines the use of universalistic assumptions about childhood adversity and mental health in driving forward this body of research. Of the 31 articles identified for this review, 23 had a focus on the psychological distress experienced by HIV-affected children, while only 8 explored social psychological pathways to improved mental health, resilience and coping. The article argues that this preoccupation with pathology reflects global assemblages of definitions, understandings and practices that constitute the global mental health framework. While such a focus is useful for policy interventions and the mobilisation of resources to support children living in HIV-affected communities, it overshadows more culturally relevant and strengths-based conceptualisations of how mental health is understood and can be achieved in different parts of Africa. Furthermore, a continued focus on the psychological distress experienced by HIV-affected children runs the risk of medicalising their social experiences, which in turn may transform the social landscape in which children give meaning to loss and difficult experiences. The article concludes that mental health professionals and researchers need to take heed of the biopolitical implications of their work, and argues for more community-oriented and resilience-enhancing research that brings forward the voices of local people to inform interventions tackling the psychosocial challenges inevitably experienced by many children in sub-Saharan Africa.
这篇文章回顾了越来越多的文献，这些文献研究了撒哈拉以南非洲受艾滋病毒影响的儿童的心理健康。该综述侧重于跨学科和方法的主要研究，审视了在推动这一研究领域中对儿童逆境和心理健康的普遍假设的使用。在为本综述确定的 31 篇文章中，有 23 篇重点关注受艾滋病毒影响的儿童所经历的心理困扰，而只有 8 篇探讨了改善心理健康、韧性和应对能力的社会心理途径。本文认为，这种对病理学的关注反映了构成全球心理健康框架的定义、理解和实践的全球集合。虽然这种关注对于政策干预和调动资源以支持生活在受艾滋病毒影响社区的儿童是有用的，但它掩盖了更符合文化的、以优势为基础的概念，即如何在非洲不同地区理解和实现心理健康。此外，继续关注受艾滋病毒影响的儿童所经历的心理困扰，有可能使他们的社会经历医学化，这反过来又可能改变儿童赋予失去和困难经历意义的社会环境。本文最后认为，心理健康专业人员和研究人员需要注意他们工作的生物政治影响，并呼吁开展更多以社区为导向和增强韧性的研究，提出当地人民的声音，为解决撒哈拉以南非洲许多儿童不可避免地面临的心理社会挑战的干预措施提供信息。
