Abstract
Taken up in the DSM-5, the Cultural Formulation Interview (CFI) is a guide for assessing cultural context of an individual’s mental health problem. Unreported before, the extent to which the cultural focus of the CFI yields religious content was explored qualitatively among patients with a current major depressive episode. Qualitative data were generated by applying the standard version of the CFI first and then reapplied it by phrasing its items in religious terms. Audio-recorded narratives so derived were typologically extracted for religious content and analysed thematically. Although only one of its questions on cultural identity explicitly refers to religion, the core CFI nonetheless yielded religious themes. These were similar to the themes emerging from the adapted CFI. They expressed inter alia, anger, shame and gains through personal (rather than organised) religion. The adapted CFI resulted in embellishment of religious content and clinically important revelations that inform on beliefs about suicide and feelings of guilt.
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References
American Psychiatric Association. (2013a). Diagnostic and statistical manual of mental disorders, fifth edition. American Psychiatric Press. Arlington, VA: American Psychiatric Publishing.
American Psychiatric Association. (2013b). Supplementary modules to the core cultural formulation interview. Retrieved from https://www.psychiatry.org/…/APA_DSM5_Cultural-Formulation-Interview-Supplementary-Modules(1).pdf.
Braam, A. W., & Koenig, H. G. (2019). Religion, spirituality and depression in prospective studies: A systematic review. Journal of Affective Disorders, 257, 428–438.
Breed, D. G., & Van Staden, C. W. (2015). A reformational Christian overview on suffering, guilt, failures, and related issues in psychiatry. In J. Z. Sadler, C. W. Van Staden, & K. W. M. Fulford (Eds.), Oxford handbook of psychiatric ethics (pp. 567–581). Oxford: Oxford University Press.
Chaze, F., Thomson, M. S., George, U., & Guruge, S. (2015). Role of cultural beliefs, religion, and spirituality in mental health and/or service utilization among immigrants in Canada: A scoping review. Canadian Journal of Community Mental Health, 34, 87–101.
Creswell, J. W. (2009). Research design; qualitative, quantitative and mixed method approaches (3rd ed.). Los Angeles, CA: SAGE.
Dein, S. (2006). Depression, spirituality and religion: implications for research and treatment. Primary Care and Community Psychiatry, 11(2), 67–72.
Dew, R. E., Daniel, S. S., Goldston, D. B., McCall, W. V., Kuchibhatla, M., Schleifer, C., et al. (2010). A prospective study of religion/spirituality and depressive symptoms among adolescent psychiatric patients. Journal Affective Disorders, 120, 149–157.
Díaz, E., Añez, L. M., Silva, M., Paris, M., & Davidson, L. (2017). Using the Cultural Formulation Interview to build culturally sensitive services. Psychiatric Services, 68(2), 112–114.
Early, K. E., & Akers, R. L. (1993). “It’s a white thing”: An exploration of beliefs about suicide in the African-American community. Deviant Behavior, 14(4), 277–296.
Exline, J. J., Yali, A. M., & Sanderson, W. C. (2000). Guilt, discord, and alienation: the role of religious strain in depression and suicidality. Journal of Clinical Psychology, 56, 1481–1496.
Glaser, B. G., & Strauss, A. L. (1967). The discovery of grounded theory: Strategies for qualitative research. Chicago, IL: Aldine.
Hays, D. G., & Singh, A. A. (2012). Qualitative inquiry in clinical and educational settings. New York, NY: The Guilford Press.
Huguelet, P., & Koenig, H. G. (2009). Religion and spirituality in psychiatry. Cambridge: Cambridge University Press.
Kirmayer, L. J., Mezzich, J. E., & Van Staden, C. W. (2016). Health experience and values in person-centered assessment and diagnosis. In J. E. Mezzich, M. Botbol, G. Christodoulou, C. R. Cloninger, & I. Salloum (Eds.), Person-centered psychiatry (pp. 179–200). Heidelberg: Springer Verlag.
Levin, J. S., & Chatters, L. M. (1998). Research on religion and mental health: An overview of empirical findings and theoretical issues. In H. G. Koenig (Ed.), Handbook of religion and mental health (pp. 33–50). San Diego, CA: Academic Press.
Lewis-Fernández, R., Aggarwal, N. K., Bäärnhielm, S., Rohlof, H., Kirmayer, L. J., Weiss, M. G., et al. (2014). Culture and psychiatric evaluation: Operationalizing cultural formulation for DSM-5. Psychiatry, 77(2), 130–154.
Lewis-Fernández, R., Aggarwal, N. K., Lam, P. C., Galfalvy, H., Weiss, M. G., Kirmayer, L. J., et al. (2017). Feasibility, acceptability and clinical utility of the Cultural Formulation Interview: Mixed-methods results from the DSM-5 international field trial. British Journal of Psychiatry, 210(4), 290–297. https://doi.org/10.1192/bjp.bp.116.193862.
McCullough, M., & Larson, D. B. (1999). Religion and depression: A review of the literature. Twin Research: The Official Journal of the International Society for Twin Studies, 2(2), 126–136.
Moreira-Almeida, A., Sharma1, A., Janse van Rensburg, B., Cook, C. C. H., & Verhagen, P. J. (2016). WPA position statement on spirituality and religion in psychiatry. Retrieved from http://www.wpanet.org/detail.php?section_id=8&content_id=1821.
Rasic, D. T., Belik, S. L., Elias, B., Katz, L. Y., Enns, M., Sareen, J., et al. (2009). Spirituality, religion and suicidal behavior in a nationally representative sample. Journal of Affective Disorders, 114, 32–40.
Royal Australian and New Zealand College of Psychiatrists. (2018). The relevance of religion and spirituality to psychiatric practice. Retrieved from https://www.ranzcp.org/news-policy/policy-and-advocacy/position-statements/the-relevance-of-religion-and-spirituality-to-psyc.
Royal College of Psychiatrists. (2011). Retrieved from https://www.rcpsych.ac.uk/pdf/PS03_2013.pdf.
Smith, T., McCullough, M., & Poll, J. (2003). Religiousness and depression: Evidence for a main effect and the moderating influence of stressful life events. Psychological Bulletin, 129, 614–636.
Stanley, M. A., Bush, A. L., Camp, M. E., Jameson, J. P., Phillips, L. L., Barber, C. R., et al. (2011). Older adults’ preferences for religion/spirituality in treatment for anxiety and depression. Aging & Mental Health, 15(3), 334–343.
Vasegh, S., Rosmarin, D. H., Koenig, H. G., Dew, R. E., & Bonelli, R. M. (2012). Religious and spiritual factors in depression. Depression Research and Treatment, 2012, 298056. https://doi.org/10.1155/2012/298056.
Verhagen, P. J., Van Praag, H. M., López-Ibor, J. J., Cox, J. L., & Moussaoui, D. (2010). Religion and psychiatry: Beyond boundaries. Chichester: John Wiley & Sons, Ltd. https://doi.org/10.1002/9780470682203.
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Pearton, T., van Staden, W. The Core Cultural Formulation Interview in Yielding Religious Content Among Patients Suffering from a Current Major Depressive Episode. J Relig Health 60, 2465–2483 (2021). https://doi.org/10.1007/s10943-020-01114-4
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DOI: https://doi.org/10.1007/s10943-020-01114-4