Ronald Wintrob

The process of acculturation: Theoretical perspectives and an empirical investigation in Peru

World-wide migratory patterns have led to an increasing interest in acculturation processes and their psychosocial and psychiatric sequelae. This paper reviews alternative theoretical approaches to the study of acculturation and identifies gaps in the current knowledge base. We then present empirical research on acculturation processes experienced by both Indian rural to urban migrants and White-Mestizo non-migrants in Lima, Peru. The study examined overall acculturation and five sub-dimensions: language use, customs, sociability, perceived discrimination and ethnic identity. The data show that second generation migrants are more highly acculturated across sub-areas and perceive less ethnic discrimination than first generation migrants. The first generation varied in acculturative level across sub-dimensions as a function of their age at the time of migration. Contrasts between the migrant and dominant group depicted a two-way process of culture change, but a process characterized by an inequality in the content exchanged in each direction. Socio-demographic correlates of acculturation were also found. These results are discussed in terms of the potential psychological consequences of alternative acculturative adaptations within the Peruvian social-structural context.

Migration and mental health in Peruvian society: Toward a psychosocial model

SummaryThis paper addresses the need for theoretical models to clarify the relationship between migration and mental health. It then elaborates one model of the psychosocial impact of rural-to-urban migration occurring within the context of Peruvian society. A set of hypotheses derived from this model is presented, and the generalizability of this model for understanding the consequences of migratory processes in divergent social settings is discussed.

Background paper on the needs of migrant, refugee and asylum seeker patients around the globe

ABSTRACT This background paper aims to better understand and classify the needs of migrant, refugee and asylum seeker patients worldwide, and provides background information on the subject.

Part of the World Psychiatric Association action plan for the triennium 2014–2017

triennium 2014–2017 Meryam Schouler-Ocak, Marianne C. Kastrup, Ronald Wintrob, Driss Moussaoui, Sergio J. Villasenor Bayardo and Xu-Dong Zhao Psychiatric University Clinic of Charité, St. Hedwig’s Hospital, Berlin, Germany; Independent Researcher; Department for Psychiatry and Human Behavior, Brown University, Providence, USA; World Psychiatric Association, World Association of Social Psychiatry, Casablanca, Morocco; Department for Psychiatry, University of Guadalajara, Adult Inpatient Psychiatry Service, Hospital Civil Fray Antonio Alcalde, Mexico; Division of Medical Humanities & Behavioral Sciences, School of Medicine of Tongji University, Department of Psychosomatic Medicine, Shanghai East Hospital, Tongji, China

Reflections on current research and future challenges in cultural psychiatry

This special issue of Transcultural Psychiatry evolved from a series of symposia organized by the Transcultural Psychiatry Section of the World Psychiatric Association (WPA-TPS) for the XV World Congress of Psychiatry, held in Buenos Aires in September 2011. WPA-TPS sponsored 10 symposia on the theme “current research in transcultural psychiatry in countries and regions around the world”, as well as an over-arching symposium on “culture and person-centered medical and psychiatric care” at the congress in Buenos Aires. The symposia on current research in transcultural psychiatry around the world, comprising more than 40 individual presentations, focused on developments in Britain, The Netherlands, German-speaking countries, Scandinavian countries, France, Russia, Spanish-speaking countries, Canada, USA, Caribbean countries and Asian-Pacific countries. Presentations at these symposia led to the series of six articles that comprise this special issue, concerning transcultural psychiatry research in Britain, The Netherlands, Germany, Scandinavia, the Caribbean and Australia. The articles include an assessment of the historical context of the development of cultural psychiatry research in each of the countries, current research themes, their scope and limitations, future directions of research, as well as issues and challenges confronting the future of cultural psychiatry. The history of transcultural psychiatry research has been characterized by efforts to establish the cross-cultural applicability and validity of psychiatric diagnostic categories. These efforts began by using standard “western” descriptive categories and diagnoses, then progressively recognizing the need to take account of the great variation in cultural conceptions of misfortune, illness, symptom expression, acceptance of the sick role, and both functional and social impairment. There is still lively debate in the field about “western diagnostic bias” and its universal, cross-cultural application on one hand, and cultural relativism, the long-term psychopathological effects of colonial exploitation, and the psychological effects of

Attitudes of Psychiatry Residents Toward a Strike by Nursing Staff

A study of the attitudes of psychiatry residents and attending psychiatrists toward a strike by nurses and mental health workers in a psychiatric teaching hospital was performed. All residents (n = 20) and 47 (83% of the attending psychiatrists) completed a questionnaire within 4 weeks after the strike. The responses to the questionnaire indicated that resident’s behavior in response to the strike was significantly different from the behavior of the attendings: 20% of the residents volunteered service during the strike compared with 66% of the attendings (p ≤ 0.0001). The attending psychiatrists, when asked what action they would have taken if they were residents, indicated somewhat less of an inclination to volunteer; 16.7% changed their position about volunteering (NS). When asked what they would have done if they were attendings, 55% (p ≤ 0.008) of the residents indicated they would have volunteered service. The significance of these findings is that residents identify themselves more with the “frontline” mental health workers engaged in the strike than with the faculty/attending psychiatrists who serve as their professional role models.

Transcultural Psychiatry: Refugee, Asylum Seeker and Immigrant Patients over the Globe

The number of refugee, asylum seeker and immigrant patients over the globe is growing dramatically, and industrialized countries are likely to receive increasing numbers of people belonging to ethnic minorities in the form of refugees and asylum seekers due to a global increase in social and political instability as well as socioeconomic conflicts. The proportion of people with a serious mental disorder such as PTSD among this population is high. Thus health-care services should prepare themselves to better serve this group of ethnic minorities. They are insufficiently prepared for this specific population of mentally ill immigrants or ethnic minority groups. Particularly, mental health care for refugee, asylum seeker and immigrant patients is lacking, e.g. in cultural competence, intercultural psychotherapy and ethnopharmacology as well as legislation related to access to and utilization of health services, and varies from country to country. Transcultural psychiatry is a discipline within psychiatry, which deals with refugee, asylum seeker and immigrant patients over the globe. This chapter will give an overview on transcultural psychiatry and psychotherapy and future perspectives.