SSM. Mental health最新文献

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Social relationship expectations, care, and loneliness in later life: Perspectives from Thai and Myanmar adults in northern Thailand 晚年的社会关系期望、关怀和孤独:泰国北部泰国和缅甸成年人的观点
SSM. Mental health Pub Date : 2023-12-04 DOI: 10.1016/j.ssmmh.2023.100279
Samia C. Akhter-Khan , Nang Myat Pont Aein , Chanyanut Wongfu , Matthew Prina , Khin Myo Wai , Rosie Mayston , Sirinan Suwannaporn
{"title":"Social relationship expectations, care, and loneliness in later life: Perspectives from Thai and Myanmar adults in northern Thailand","authors":"Samia C. Akhter-Khan ,&nbsp;Nang Myat Pont Aein ,&nbsp;Chanyanut Wongfu ,&nbsp;Matthew Prina ,&nbsp;Khin Myo Wai ,&nbsp;Rosie Mayston ,&nbsp;Sirinan Suwannaporn","doi":"10.1016/j.ssmmh.2023.100279","DOIUrl":"https://doi.org/10.1016/j.ssmmh.2023.100279","url":null,"abstract":"<div><p>Loneliness results from unfulfilled social relationship expectations (SREs). Little research has investigated how SREs vary by culture and context, how loneliness is experienced in rural Southeast Asia, and how loneliness relates to care provision in later life. The current study qualitatively explored the understanding of loneliness, contextual differences in the content, avenues, and obstacles for SREs, and care provided by Myanmar and Thai people living at the border in Chiang Rai. Data were analysed using thematic analysis. Between November and December 2022, 10 focus group discussions were held with 17 migrants from Myanmar and 33 older people from Thailand. Emerging themes from the focus groups shed light on how loneliness differs between cultures and contexts. Loneliness was experienced particularly at night, when people thought about their unmet relationship expectations. Having “nothing to do” and overthinking were closely related to the experience of loneliness, whereas engaging in activities, including caregiving, alleviated loneliness. Compared to Myanmar adults, Thai older adults were more likely to have family members nearby but less likely to share personal problems and feelings of loneliness with others. Fulfilling the SREs of proximity, generativity, and respect was more challenging for Myanmar migrants, who had been unable to return home for years while struggling with financial insecurity.</p></div>","PeriodicalId":74861,"journal":{"name":"SSM. Mental health","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666560323000944/pdfft?md5=8a1f9d926fbd0e4e9e7f5a05ccd8c1b8&pid=1-s2.0-S2666560323000944-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138557415","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Psychosocial support during the COVID-19 pandemic in informal settlements: A Case of Childcare Providers in Nairobi, Kenya 2019冠状病毒病大流行期间非正规住区的社会心理支持:以肯尼亚内罗毕托儿服务提供者为例
SSM. Mental health Pub Date : 2023-12-01 DOI: 10.1016/j.ssmmh.2023.100240
Ivy Chumo, Blessing Mberu, Hellen Gitau, Ivy Nandongwa, Yohannes Dibaba, Caroline Kabaria
{"title":"Psychosocial support during the COVID-19 pandemic in informal settlements: A Case of Childcare Providers in Nairobi, Kenya","authors":"Ivy Chumo,&nbsp;Blessing Mberu,&nbsp;Hellen Gitau,&nbsp;Ivy Nandongwa,&nbsp;Yohannes Dibaba,&nbsp;Caroline Kabaria","doi":"10.1016/j.ssmmh.2023.100240","DOIUrl":"https://doi.org/10.1016/j.ssmmh.2023.100240","url":null,"abstract":"","PeriodicalId":74861,"journal":{"name":"SSM. Mental health","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49904668","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The feasibility of a Community Mental Health Education and Detection (CMED) tool in South Africa. 南非社区心理健康教育和检测(CMED)工具的可行性。
IF 4.1
SSM. Mental health Pub Date : 2023-12-01 Epub Date: 2023-01-17 DOI: 10.1016/j.ssmmh.2023.100188
Merridy Grant, Arvin Bhana, Tasneem Kathree, Nonkululeko Khuzwayo, André J van Rensburg, Londiwe Mthethwa, Sithabisile Gigaba, Ellen Ntswe, Zamasomi Luvuno, Inge Petersen
{"title":"The feasibility of a Community Mental Health Education and Detection (CMED) tool in South Africa.","authors":"Merridy Grant, Arvin Bhana, Tasneem Kathree, Nonkululeko Khuzwayo, André J van Rensburg, Londiwe Mthethwa, Sithabisile Gigaba, Ellen Ntswe, Zamasomi Luvuno, Inge Petersen","doi":"10.1016/j.ssmmh.2023.100188","DOIUrl":"10.1016/j.ssmmh.2023.100188","url":null,"abstract":"<p><strong>Background: </strong>Poor mental health literacy, misinformation about treatment and stigma result in low demand for mental health services in low-and middle-income countries. Community-based interventions that raise mental health awareness and facilitate detection of mental health conditions, are instrumental in increasing demand through strengthened mental health literacy, as well as supply of available mental health services through strengthened detection and linkage to care.</p><p><strong>Objective: </strong>To assess the feasibility of a Community Mental Health Education and Detection Tool (CMED) for use with household members by community health teams in South Africa.</p><p><strong>Methods: </strong>The feasibility of using the CMED in households was assessed using Bowen et al.'s framework which informed the study design, interview tools and analysis. The feasibility study involved four phases: (1) observations of the CMED consultation to evaluate the administration of the tool; (2) semi-structured interviews with household member/s after the CMED was administered to explore experiences of the visit; (3) follow-up interviews of household members referred using the CMED tool to assess uptake of referrals; (4) and weekly focus group discussions with the community health team to explore experiences of using the tool. Framework analysis was used to inform <i>a priori</i> themes and allow inductive themes to emerge from the data.</p><p><strong>Results: </strong>The CMED was found to be acceptable by both community health teams and household members, demand for the tool was evident, implementation, practicality and integration within the existing health system were also indicated.</p><p><strong>Conclusion: </strong>The CMED is perceived as feasible by household members and community health teams, suggesting a 'goodness of fit\" within the existing health system.</p>","PeriodicalId":74861,"journal":{"name":"SSM. Mental health","volume":null,"pages":null},"PeriodicalIF":4.1,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11189615/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"55067857","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Social support and user engagement with task-shared psychological treatments in the real world: Findings from the PRIME India study 现实世界中任务共享心理治疗的社会支持和用户参与:来自PRIME印度研究的发现
SSM. Mental health Pub Date : 2023-12-01 DOI: 10.1016/j.ssmmh.2023.100257
Saloni Dev , John Griffith , Vikram Patel , Alisa Lincoln
{"title":"Social support and user engagement with task-shared psychological treatments in the real world: Findings from the PRIME India study","authors":"Saloni Dev ,&nbsp;John Griffith ,&nbsp;Vikram Patel ,&nbsp;Alisa Lincoln","doi":"10.1016/j.ssmmh.2023.100257","DOIUrl":"https://doi.org/10.1016/j.ssmmh.2023.100257","url":null,"abstract":"","PeriodicalId":74861,"journal":{"name":"SSM. Mental health","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49881722","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 1
Experience of primary healthcare workers in using the mobile app-based WHO mhGAP intervention guide in detection and treatment of people with mental disorders: A qualitative study in Nepal 初级卫生保健工作者使用基于移动应用程序的世卫组织mhGAP干预指南检测和治疗精神障碍患者的经验:尼泊尔的一项定性研究
SSM. Mental health Pub Date : 2023-11-29 DOI: 10.1016/j.ssmmh.2023.100278
Nagendra P. Luitel , Vibha Neupane , Bishnu Lamichhane , Gobinda Prasad Koirala , Kamal Gautam , Eliza Karki , Sandarba Adhikari , Nicole Votruba , Mark JD. Jordans , Brandon A. Kohrt , Kenneth Carswell , Graham Thornicroft , Heidi Lempp
{"title":"Experience of primary healthcare workers in using the mobile app-based WHO mhGAP intervention guide in detection and treatment of people with mental disorders: A qualitative study in Nepal","authors":"Nagendra P. Luitel ,&nbsp;Vibha Neupane ,&nbsp;Bishnu Lamichhane ,&nbsp;Gobinda Prasad Koirala ,&nbsp;Kamal Gautam ,&nbsp;Eliza Karki ,&nbsp;Sandarba Adhikari ,&nbsp;Nicole Votruba ,&nbsp;Mark JD. Jordans ,&nbsp;Brandon A. Kohrt ,&nbsp;Kenneth Carswell ,&nbsp;Graham Thornicroft ,&nbsp;Heidi Lempp","doi":"10.1016/j.ssmmh.2023.100278","DOIUrl":"https://doi.org/10.1016/j.ssmmh.2023.100278","url":null,"abstract":"<div><p>This study assessed perception and experience of trained primary health care workers in using a mobile app-based version of the WHO mental health gap action programme (mhGAP) Intervention Guide in the assessment and management of people with mental health conditions in primary care in Nepal. A qualitative study was conducted with primary healthcare workers who were trained in using the WHO mhGAP mobile application in Jhapa, a district in eastern Nepal. Semi-structured interviews were carried out with 15 healthcare workers (3 females and 12 males) nine months after the training. Interviews were audio recorded, transcribed and translated into English for the thematic qualitative data analysis. Health care workers (HCWs) found the mobile app helpful to verify and confirm their assessment and diagnosis. The other benefits reported by the participants were: bringing uniformity in diagnosis and management of mental health conditions across primary healthcare facilities; reminding the HCWs specific assessment questions; creating awareness on the importance of psychosocial intervention; improving the interaction between patients and service providers; and the importance of follow-up care. Despite these advantages, lack of clarity about report submission modality; lack of electricity or internet connectivity; and low technology literacy among older HCWs were some of the barriers in using the app. The major recommendation made by the HCWs for the guide included revision of the assessment process and system; inclusion of a chat function with supervisors; minimizing the amount of patients’ data to be collected in the app; and addition of conversion and anxiety disorders to the app. This study concludes that the mobile decision support application could be acceptable and feasible in primary care settings if the suggested modifications are incorporated, in addition to addressing other systemic issues facing the primary care-based delivery of mental health services.</p></div>","PeriodicalId":74861,"journal":{"name":"SSM. Mental health","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666560323000932/pdfft?md5=720d7ef6e277b2ff842889db61695ef7&pid=1-s2.0-S2666560323000932-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138501901","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Mental health in India: Sociocultural dimensions, policies and programs – An introduction to the India series 印度的心理健康:社会文化层面、政策和方案——印度系列简介
SSM. Mental health Pub Date : 2023-11-27 DOI: 10.1016/j.ssmmh.2023.100277
Venkatesan Chakrapani , Shalini Bharat
{"title":"Mental health in India: Sociocultural dimensions, policies and programs – An introduction to the India series","authors":"Venkatesan Chakrapani ,&nbsp;Shalini Bharat","doi":"10.1016/j.ssmmh.2023.100277","DOIUrl":"https://doi.org/10.1016/j.ssmmh.2023.100277","url":null,"abstract":"","PeriodicalId":74861,"journal":{"name":"SSM. Mental health","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666560323000920/pdfft?md5=3f3cc0e33e3d1acfc0899e18ea45ad2a&pid=1-s2.0-S2666560323000920-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138474194","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
(Men)tal health: Perceptions of depression in men and women (男子)心理健康:男子和妇女对抑郁症的看法
SSM. Mental health Pub Date : 2023-11-23 DOI: 10.1016/j.ssmmh.2023.100275
Nina Freiberger , Teresa Lynch , Glenna L. Read , Alexandra M. Blouin
{"title":"(Men)tal health: Perceptions of depression in men and women","authors":"Nina Freiberger ,&nbsp;Teresa Lynch ,&nbsp;Glenna L. Read ,&nbsp;Alexandra M. Blouin","doi":"10.1016/j.ssmmh.2023.100275","DOIUrl":"https://doi.org/10.1016/j.ssmmh.2023.100275","url":null,"abstract":"<div><p>Despite evidence indicating that depression is prevalent in men, gender stereotypes persist that position the disorder as feminine. This misperception may contribute to men's underdiagnosis with and undertreatment for depression. We applied the shifting standards model (SSM) to advance predictions about gender differences in the evaluation of individuals described as experiencing depression. These predictions took the form of objective and subjective evaluations, as well as minimum and confirmatory standards. We randomly assigned participants (<em>N</em> = 430) in a 3 (target gender: man, woman, control) x 2 (judgment standards: minimum, confirmatory) between-subjects experiment. Participants read a vignette describing a woman, man, or individual of unspecified gender and provided the evidence they would need to suspect or confirm depression in the target individual consistent with minimum and confirmatory judgment standards. Results from the pilot and main studies indicate more gender similarities than differences. We discuss the findings with respect to the SSM and how the increase in mental health salience during the COVID-19 pandemic may have mitigated gender stereotypical views of depression.</p></div>","PeriodicalId":74861,"journal":{"name":"SSM. Mental health","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-11-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666560323000907/pdfft?md5=36835aa9e972b8bf905fb705a239c4ed&pid=1-s2.0-S2666560323000907-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138472035","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Trauma, genes, or spirits? Development of a scale to provide a more nuanced understanding of refugees' causal attributions for mental health problems 创伤,基因,还是精神?制定一个量表,以便更细致地了解难民对心理健康问题的因果归因
SSM. Mental health Pub Date : 2023-11-23 DOI: 10.1016/j.ssmmh.2023.100276
Lars Dumke, Sarah Wilker, Hawkar Ibrahim, Cara Hohaus, Frank Neuner
{"title":"Trauma, genes, or spirits? Development of a scale to provide a more nuanced understanding of refugees' causal attributions for mental health problems","authors":"Lars Dumke,&nbsp;Sarah Wilker,&nbsp;Hawkar Ibrahim,&nbsp;Cara Hohaus,&nbsp;Frank Neuner","doi":"10.1016/j.ssmmh.2023.100276","DOIUrl":"https://doi.org/10.1016/j.ssmmh.2023.100276","url":null,"abstract":"<div><p>Only a small proportion of refugees requiring treatment actually receive psychotherapy. Alongside structural barriers, it has been hypothesized that causal attributions for mental health problems that deviate from Western explanatory models may reduce refugees' help-seeking behavior. Prevailing assumptions suggest that refugees predominantly hold causal beliefs that are incompatible with the rationales of psychotherapy. Testing these assumptions requires a reliable assessment tool to evaluate refugees' causal beliefs. Therefore, we developed the Causal Attributions for Mental Health Problems Scale (MH-CAUSE) and validated it in a sample of Middle Eastern refugees living in Germany (<em>N</em> = 429). The outcomes of the psychometric analysis, which included exploratory and confirmatory factor analysis, internal consistency, and convergent validity, indicate that the MH-CAUSE is a suitable instrument for assessing refugees' causal beliefs about mental health problems. Our findings suggest that refugees' causal attributions are in line with a biopsychosocial-spiritual model of mental illness. Contrary to common assumptions, the majority of participants predominantly explained mental illness via psychosocial and biomedical causes, whereas spiritual beliefs were relevant only for a minority of participants. We observed significant associations between causal beliefs and help-seeking attitudes and behavior. However, effect sizes were only small to moderate. While mental health beliefs might contribute to mental health inequities, alleged cultural differences of refugees should not be overemphasized.</p></div>","PeriodicalId":74861,"journal":{"name":"SSM. Mental health","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-11-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666560323000919/pdfft?md5=6a52bc669b40b9f4d6d88b8be8325fdf&pid=1-s2.0-S2666560323000919-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138448052","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
What does it mean to flourish, languish, and grow? A qualitative analysis of civilian interviews from survivors of the 1994 Rwandan genocide 繁荣、衰弱和成长是什么意思?对1994年卢旺达种族灭绝幸存者平民访谈的定性分析
SSM. Mental health Pub Date : 2023-11-20 DOI: 10.1016/j.ssmmh.2023.100274
Linn Zapffe , Kaitlyn Hennig , Nuwan Jayawickreme , Eranda Jayawickreme
{"title":"What does it mean to flourish, languish, and grow? A qualitative analysis of civilian interviews from survivors of the 1994 Rwandan genocide","authors":"Linn Zapffe ,&nbsp;Kaitlyn Hennig ,&nbsp;Nuwan Jayawickreme ,&nbsp;Eranda Jayawickreme","doi":"10.1016/j.ssmmh.2023.100274","DOIUrl":"https://doi.org/10.1016/j.ssmmh.2023.100274","url":null,"abstract":"<div><p>The current study investigated characteristics of resilience and posttraumatic growth in a sample of Rwandan genocide survivors. One hundred and sixty-three participants provided responses to a series of open-ended questions about resilient functioning among members of their community, as well as their own experiences of posttraumatic growth since the genocide. An overall theme in the responses was the role of environmental characteristics in both resilience and posttraumatic growth, which was apparent through the high frequency of codes such as family, means, work, and education. Furthermore, there was considerable overlap in identified domains of resilient functioning and posttraumatic growth. The results suggest that in this particular context, resilience is predominantly characterized by environmental features rather than individual characteristics. This has implications for interventions in Rwanda as well as the validity of current models and measures of resilience and posttraumatic growth in different cultures.</p></div>","PeriodicalId":74861,"journal":{"name":"SSM. Mental health","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666560323000890/pdfft?md5=c37d3de4852c9ae0b2a5313723172d4d&pid=1-s2.0-S2666560323000890-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138396626","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Accounting for the interplay of interpersonal and structural trauma in the treatment of chronic non-cancer pain, opioid use disorder, and mental health in urban safety-net primary care clinics. 在城市安全网初级保健诊所治疗慢性非癌性疼痛、阿片类药物使用障碍和心理健康的过程中,考虑人际创伤和结构性创伤的相互作用。
SSM. Mental health Pub Date : 2023-11-15 Epub Date: 2023-07-07 DOI: 10.1016/j.ssmmh.2023.100243
Stacy Castellanos, Alexis Cooke, Sedona Koenders, Neena Joshi, Christine Miaskowski, Margot Kushel, Kelly Ray Knight
{"title":"Accounting for the interplay of interpersonal and structural trauma in the treatment of chronic non-cancer pain, opioid use disorder, and mental health in urban safety-net primary care clinics.","authors":"Stacy Castellanos, Alexis Cooke, Sedona Koenders, Neena Joshi, Christine Miaskowski, Margot Kushel, Kelly Ray Knight","doi":"10.1016/j.ssmmh.2023.100243","DOIUrl":"10.1016/j.ssmmh.2023.100243","url":null,"abstract":"<p><p>While the epidemiological literature recognizes associations between chronic non-cancer pain (CNCP), opioid use disorder (OUD), and interpersonal trauma stemming from physical, emotional, sexual abuse or neglect, the complex etiologies and interplay between interpersonal and structural traumas in CNCP populations are underexamined. Research has documented the relationship between experiencing multiple adverse childhood experiences (ACEs) and the likelihood of developing an OUD as an adult. However, the ACEs framework is criticized for failing to name the social and structural contexts that shape ACE vulnerabilities in families. Social scientific theory and ethnographic methods offer useful approaches to explore how interpersonally- and structurally-produced traumas inform the experiences of co-occurring CNCP, substance use, and mental health. We report findings from a qualitative and ethnographic longitudinal cohort study of patients with CNCP (n = 48) who received care in safety-net settings and their primary care providers (n = 23). We conducted semi-structured interviews and clinical and home-based participant observation from 2018 to 2020. Here we focus our analyses on how patients and providers explained and situated the role of patient trauma in the larger clinical context of reductions in opioid prescribing to highlight the political landscape of the United States opioid overdose crisis and its impact on clinical interactions. Findings reveal the disproportionate burden structurally-produced, racialized trauma places on CNCP, substance use and mental health symptoms that shapes patients' embodied experiences of pain and substance use, as well as their emotional experiences with their providers. Experiences of trauma impacted clinical care trajectories, yet providers and patients expressed limited options for redress. We argue for an adaptation of trauma-informed care approaches that contextualize the structural determinants of trauma and their interplay with interpersonal experiences to improve clinical care outcomes.</p>","PeriodicalId":74861,"journal":{"name":"SSM. Mental health","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10923552/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"55068370","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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