Kirmayer L J, Fletcher C M, Boothroyd L J
Department of Psychiatry, Sir Mortimer B. Davis-Jewish General Hospital, Montréal, QC.
J Nerv Ment Dis. 1997 Feb;185(2):78-86. doi: 10.1097/00005053-199702000-00003.
Attitudes toward deviant behavior that might indicate psychiatric disorder were investigated among the Inuit of Northern Québec (Nunavik). In a convenience sample of 137 Inuit adults, respondents were randomly presented with one of six different vignettes that described a man with "strange" behavior who was either threatening or withdrawn and whose problem was labeled either "isumaluttuq" ("burdened or weighed down by thoughts"), "demon possession," or "mental illness." Respondents rated their willingness to live, work, or hunt with this person and allow him into their family on a social distance scale. Significant predictors of greater social distance were female gender, more education, less familiarity with the behavior, and perception of the person as less likely to recover. There were no significant effects of vignette behavior or label on social distance ratings. Rating of likelihood of recovery was influenced by the vignette label, with isumaluttuq associated with less chance of recovery. Ascribing strange behavior to morally wrong action and to spirits or demons were highly inter-correlated and each was associated with perception of greater likelihood of recovery. Results suggest that Inuit attitudes toward deviant behavior are influenced more by perceived familiarity and likelihood of recovery than by labels, causal attributions, or explanations. The indigenous psychological concept of isumaluttuq does not serve to reduce social stigma. Efforts to promote the community integration of psychiatric patients through education should aim to increase familiarity with the problematic behavior and emphasize potential for recovery.
魁北克北部因纽特人（努纳维克地区）对可能表明精神疾病的异常行为的态度接受了调查。在一个由137名因纽特成年人组成的便利样本中，受访者被随机呈现六个不同的 vignette 之一，这些 vignette 描述了一个行为“怪异”的男子，他要么具有威胁性，要么性格孤僻，其问题被标记为“isumaluttuq”（“被思想负担或压垮”）、“被恶魔附身”或“精神疾病”。受访者根据社会距离量表对与这个人一起生活、工作或狩猎以及让他融入自己家庭的意愿进行评分。社会距离越大的显著预测因素包括女性性别、受教育程度越高、对该行为的熟悉程度越低以及认为此人康复可能性越小。vignette 中的行为或标签对社会距离评分没有显著影响。康复可能性的评分受 vignette 标签的影响，“isumaluttuq”与康复机会较少相关。将奇怪行为归因于道德错误行为以及灵魂或恶魔的情况高度相互关联，并且每一种都与更高的康复可能性认知相关。结果表明，因纽特人对异常行为的态度更多地受到感知到的熟悉程度和康复可能性的影响，而不是标签、因果归因或解释。本土心理概念“isumaluttuq”并不能减少社会污名。通过教育促进精神疾病患者社区融合的努力应旨在增加对问题行为的熟悉程度，并强调康复的潜力。
