Department of Epidemiology, Columbia University, New York, NY, USA, Health Service and Population Research Department, Institute of Psychiatry, King's College London, London, UK, Academic Division in Promotion of Health, School of Public Health, University of Chile Santiago, Chile and Mental Health Association of San Francisco, San Francisco, CA, USA.
Int J Epidemiol. 2014 Apr;43(2):494-510. doi: 10.1093/ije/dyu039. Epub 2014 Mar 16.
While stigma measurement across cultures has assumed growing importance in psychiatric epidemiology, it is unknown to what extent concepts arising from culture have been incorporated. We utilize a formulation of culture-as the everyday interactions that 'matter most' to individuals within a cultural group-to identify culturally-specific stigma dynamics relevant to measurement.
A systematic literature review from January 1990 to September 2012 was conducted using PsycINFO, Medline and Google Scholar to identify articles studying: (i) mental health stigma-related concepts; (ii) ≥ 1 non-Western European cultural group. From 5292 abstracts, 196 empirical articles were located.
The vast majority of studies (77%) utilized adaptations of existing Western-developed stigma measures to new cultural groups. Extremely few studies (2.0%) featured quantitative stigma measures derived within a non-Western European cultural group. A sizeable amount (16.8%) of studies employed qualitative methods to identify culture-specific stigma processes. The 'what matters most' perspective identified cultural ideals of the everyday activities that comprise 'personhood' of 'preserving lineage' among specific Asian groups, 'fighting hard to overcome problems and taking advantage of immigration opportunities' among specific Latino-American groups, and 'establishing trust among religious institutions due to institutional discrimination' among African-American groups. These essential cultural interactions shaped culture-specific stigma manifestations. Mixed method studies (3.6%) corroborated these qualitative results.
Quantitatively-derived, culturally-specific stigma measures were lacking. Further, the vast majority of qualitative studies on stigma were conducted without using stigma-specific frameworks. We propose the 'what matters most' approach to address this key issue in future research.
虽然跨文化精神疾病流行病学领域对污名的衡量越来越重要，但目前尚不清楚有多少源于文化的概念已被纳入其中。我们利用文化的一种表述方式，即“对文化群体中的个体最重要的日常互动”，来确定与测量相关的、具有文化特异性的污名动态。
通过 PsycINFO、Medline 和 Google Scholar 进行了从 1990 年 1 月至 2012 年 9 月的系统文献综述，以确定研究以下内容的文章：（i）心理健康污名相关概念；（ii）≥1 个非西方欧洲文化群体。从 5292 个摘要中，确定了 196 篇实证文章。
绝大多数研究（77%）使用了现有的西方开发的污名测量方法来适应新的文化群体。极少数研究（2.0%）采用了源自非西方欧洲文化群体的定量污名测量方法。相当数量（16.8%）的研究采用定性方法来确定特定的文化污名过程。“最重要的是什么”的观点确定了特定亚洲群体的“人格”和“维持家族”的日常活动的文化理想，特定拉丁裔美国群体的“努力克服问题和利用移民机会”的文化理想，以及非洲裔美国群体的“由于机构歧视而在宗教机构中建立信任”的文化理想。这些基本的文化互动塑造了具有文化特异性的污名表现。混合方法研究（3.6%）证实了这些定性结果。
缺乏定量得出的、具有文化特异性的污名测量方法。此外，大多数关于污名的定性研究都没有使用特定的污名框架。我们建议采用“最重要的是什么”方法来解决未来研究中的这一关键问题。
