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The Explanatory Model Interview Catalogue (EMIC)

Contribution to Cross-cultural Research Methods from a Study of Leprosy and Mental Health

Published online by Cambridge University Press:  02 January 2018

Mitchell G. Weiss ,
D. R. Doongaji ,
S. Siddhartha ,
David Wypij ,
S. Pathare ,
M. Bhatawdekar ,
A. Bhave ,
A. Sheth  and
R. Fernandes
Mitchell G. Weiss*
Affiliation:
Departments of Psychiatry and Social Medicine, Harvard Medical School, Boston, Massachusetts and Department of Psychiatry, The Cambridge Hospital, Cambridge, Massachusetts, USA
D. R. Doongaji
Affiliation:
Department of Psychiatry, KEM Hospital, Bombay, India
S. Siddhartha
Affiliation:
Department of Psychiatry, KEM Hospital, Bombay
David Wypij
Affiliation:
Department of Biostatistics, Harvard School of Public Health, Boston, Massachusetts
S. Pathare
Affiliation:
Department of Psychiatry, KEM Hospital, Bombay
M. Bhatawdekar
Affiliation:
Bombay
A. Bhave
Affiliation:
Department of Psychiatry, Nair Hospital, Bombay
A. Sheth
Affiliation:
Department of Psychiatry, KEM Hospital, Bombay
R. Fernandes
Affiliation:
Department of Dermatology, KEM Hospital, Bombay
*
∗Department of Social Medicine, Harvard Medical School, 641 Huntington Avenue, Boston, Massachusetts 02115, USA
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Abstract

The Explanatory Model Interview Catalogue (EMIC) has been developed to elicit illness-related perceptions, beliefs, and practices in a cultural study of leprosy and mental health in Bombay. Leprosy is an especially appropriate disorder for studying the inter-relationship of culture, mental health and medical illness because of deeply rooted cultural meanings, the emotional burden, and underuse of effective therapy. Fifty per cent of 56 recently diagnosed leprosy out-patients, 37% of 19 controls with another stigmatised dermatological condition (vitiligo), but only 8% of 12 controls with a comparable non-stigmatised condition (tinea versicolor) met DSM–III–R criteria for an axis I depressive, anxiety or somatoform disorder. Belief in a humoral (traditional) cause of illness predicted better attendance at clinic.

Type
Papers
Information
The British Journal of Psychiatry , Volume 160 , Issue 6 , June 1992 , pp. 819 - 830
Copyright
Copyright © The Royal College of Psychiatrists 

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References

Babb, L. A. (1983) Destiny and responsibility: karma in popular Hinduism. In Karma: An Anthropological Inquiry (eds Keyes, C. F. & Daniel, E. G.), pp. 163–181. Berkeley: University of California Press.Google Scholar
Behere, P. B. (1981) Psychological reactions to leprosy. Leprosy in India, 53, 266–272.Google ScholarPubMed
Berreman, J. M. (1984) Childhood leprosy and social response in South India. Social Science and Medicine, 19, 853–865.CrossRefGoogle ScholarPubMed
Bhaskaran, K. (1990) Undergraduate training in psychiatry and behavioural sciences – the need to train the trainers. Indian Journal of Psychiatry, 32, 1–3.Google ScholarPubMed
Bhattacharyya, D. (1983) Psychiatric pluralism in Bengal, India. Social Science and Medicine, 17, 947–956.CrossRefGoogle ScholarPubMed
Brislin, R. W. (1976) Comparative research methodology: cross-cultural studies. International Journal of Psychology, 11, 215–229.CrossRefGoogle Scholar
Cazanavette, L. L. (1927) Mental aspect of leprosy. Journal of the American Medical Association, 89, 1496–1500.CrossRefGoogle Scholar
Chauhan, N. S., Ramu, G. & Dhar, U. (1982) Leprosy as a correlate of anxiety on the self-erosion dimension. Leprosy in India, 54, 505–511.Google Scholar
Chen, P. C. Y. (1988) Longhouse dwelling, social contact and the prevalence of leprosy and tuberculosis among native tribes of Sarawak. Social Science and Medicine, 26, 1073–1077.Google Scholar
Derogatis, L. R., Morrow, G. R., Fetting, J., et al (1983) The prevalence of psychiatric disorders among cancer patients. Journal of the American Medical Association, 249, 751–757.Google Scholar
Dohrenwend, B. P. & Dohrenwend, B. S. (1974) Social and cultural influences on psychopathology. Annual Reviews of Psychology, 25, 417–452.CrossRefGoogle ScholarPubMed
Evans, D. L., McCartney, C. F., Nemeroff, C. B., et al (1986) Depression in women treated for gynecological cancer: clinical and neuroendocrine assessment. American Journal of Psychiatry, 143, 447–452.Google ScholarPubMed
Fassin, D. (1990) Influence of social perceptions of leprosy and leprosy patients on public health programs. International Journal of Leprosy and Other Mycobacterial Diseases, 58, 111–114.Google ScholarPubMed
Fawzy, F. I., Cousins, N., Fawzy, N. W., et al (1990) A structured psychiatric intervention for cancer patients: changes over time in methods of coping and affective disturbance. Archives of General Psychiatry, 47, 720–725.Google Scholar
Foulks, E. F., Persons, J. B. & Merkel, R. L. (1986) The effect of patients' beliefs about their illnesses on compliance in psychotherapy. American Journal of Psychiatry, 143, 340–344.Google ScholarPubMed
Gokhale, J. B. (1986) The sociopolitical effects of ideological change: the Buddhist conversion of Maharashtrian untouchables. Journal of Asian Studies, 45, 269–292.Google Scholar
Good, M. J., Good, B. J., Schaffer, C., et al (1990) American oncology and the discourse on hope. Culture, Medicine and Psychiatry, 14, 59–80.Google Scholar
Havik, O. E. & Maeland, J. G. (1988) Verbal denial and outcome in myocardial infarction patients. Journal of Psychosomatic Research, 32, 145–157.Google Scholar
Headland, T. N., Pike, K. L. & Harris, M. (eds) (1990) Emics and Etics: The Insider/Outsider Debate. Frontiers of Anthropology Series, No. 7. Newbury Park: Sage Publications.Google Scholar
Jolly, J. (1977) Indian Medicine (trans. Kashikar, C. G.) (2nd edn, revised). Delhi: Munshiram, Manoharlal.Google Scholar
Jopling, W. H. (1991) Leprosy stigma (editorial). Leprosy Review, 62, 1–12.Google Scholar
Khandelwal, S. K. & Workneh, F. (1986) Perceptions of mental illness by medical students. Indian Journal of Psychological Medicine, 9, 26–32.CrossRefGoogle Scholar
Kleinman, A. (1977) Depression, somatization and the “new cross-cultural psychiatry”. Social Science and Medicine, 11, 3–10.Google Scholar
Kleinman, A. (1980) Patients and Healers in the Context of Culture. Berkeley: University of California Press.Google Scholar
Kleinman, A. (1988) Rethinking Psychiatry: Six Anthropological Questions. New Haven: Yale University Press.Google Scholar
Leslie, C. (1980) Medical pluralism in world perspective. Social Science and Medicine, 14B, 191–195.Google Scholar
Littlewood, R. (1990) From categories to contexts: a decade of the ‘new cross-cultural psychiatry’. British Journal of Psychiatry, 156, 308–327.Google Scholar
Littlewood, R. & Lipsedge, M. (1989) Aliens and Alienists: Ethnic Minorities and Psychiatry (2nd edn). London: Unwin Hyman.Google Scholar
Lowinger, P. (1959) Leprosy and psychosis. American Journal of Psychiatry, 116, 32–37.Google Scholar
Lowinger, P. (1974) Follow-up on leprosy and psychosis. American Journal of Psychiatry, 131, 607.Google Scholar
Manson, S. M., Shore, J. H. & Bloom, J. D. (1985) The depressive experience in American Indian Communities: a challenge for psychiatric theory and diagnosis. In Culture and Depression (eds Kleinman, A. & Good, B.), pp. 331–368. Berkeley: University of California Press.CrossRefGoogle Scholar
Mather, R. J. & John, T. J. (1973) Popular beliefs about smallpox and other common infectious diseases in South India. Tropical and Geographical Medicine, 25, 190–196.Google Scholar
Matthews, C. M. E. (1979) Health and Culture in a South Indian Village. New Delhi: Sterling Publishers.Google Scholar
Morbidity and Mortality Weekly Report (1990) Health beliefs and compliance with prescribed medication for hypertension among black women – New Orleans, 1985–86. Morbidity and Mortality Weekly Report, 39, 701–704.Google Scholar
Mull, J. D., Wood, C. S., Gans, L. P., et al (1989) Culture and “compliance” among leprosy patients in Pakistan. Social Science and Medicine, 29, 799–811.CrossRefGoogle ScholarPubMed
Murphy, H. B. M. (1969) Handling the cultural dimension in psychiatric research. Social Science and Medicine, 4, 11–15.Google Scholar
Murray, C. J., Styblo, K. & Rouillon, A. (1990) Tuberculosis in developing countries: burden, intervention and cost. Bulletin of the International Union Against Tuberculosis and Lung Disease, 65, 2–20.Google ScholarPubMed
Neylan, T. C., Nelson, K. E., Schauf, V., et al (1988) Illness beliefs of leprosy patients: use of medical anthropology in clinical practice. International Journal of Leprosy, 56, 231–237.Google Scholar
Nichols, R. W. (1981) The Goddess Sitala and epidemic smallpox in Bengal. Journal of Asian Studies, 41, 21–44.Google Scholar
Olivier, H. R. (1987) Psychiatric aspects of Hansen's disease (leprosy). Journal of Clinical Psychiatry, 48, 477–479.Google Scholar
Park, J. E. & Park, K. (1985) Textbook of Preventive and Social Medicine (10th edn). Jabalpur: Banarsidas Bhanot.Google Scholar
Revankar, C. R. & Ganapati, R. (1988) Leprosy endemicity – its magnitude in Bombay. In Studies on Leprosy by Bombay Leprosy Project: 1976–1986 (Bombay Leprosy Project), pp. 90–94. Bombay: Bombay Leprosy Project.Google Scholar
Robins, L. N. & Barrett, J. N. (eds) (1989) The Validity of Psychiatric Diagnosis. New York: Raven Press.Google Scholar
Sartorius, N. (1973) Culture and the epidemiology of depression. Psychiatria, Neurologic Neurochirurgia, 76, 479–487.Google Scholar
Skultans, V. (1987) The management of mental illness among Maharashtrian families: a case study of a Mahanubhav healing temple. Man, 22, 661–679.CrossRefGoogle Scholar
Spiegel, D., Bloom, J. R., Kraemer, H. C., et al (1989) Effect of psychosocial treatment on survival of patients with metastatic breast cancer. Lancet, ii, 888–891.Google Scholar
Spitzer, R. L., Williams, J. B. W., Gibbon, M., et al (1988) Structured Clinical Interview for DSM–III–R – Non-Patient Version. New York: Biometrics Research Department, New York State Psychiatric Institute.Google Scholar
Stanley, J. M. (1988) Gods, ghosts, and possession. In The Experience of Hinduism (eds Zelliot, E. & Bertsen, M.), pp. 26–59. New York: State University of New York.Google Scholar
Strauss, D. H., Spitzer, R. L. & Muskin, P. R. (1990) Maladaptive denial of physical illness: a proposal for DSM–IV. American Journal of Psychiatry, 147, 1168–1172.Google Scholar
Suls, J. & Fletcher, B. (1985) The relative efficacy of avoidant and nonavoidant coping strategies: a meta-analysis. Health and Psychology, 4, 249–288.Google Scholar
Taylor, C. E. (1976) The place of indigenous medical practitioners in the modernization of health services. In Asian Medical Systems: A Comparative Study (ed. Leslie, C.), pp. 285–299. Berkeley: University of California Press.CrossRefGoogle Scholar
Verghese, A., Matthew, P. M., Senseman, L. A., et al (1971) Psychosomatic aspects of rehabilitation in leprosy. International Journal of Leprosy, 39, 842–847.Google ScholarPubMed
Weiss, M. G., Sharma, S. D., Gaur, R. K., et al (1986) Traditional concepts of mental disorder among Indian psychiatric patients. Social Science and Medicine, 23, 379–386.CrossRefGoogle ScholarPubMed
Weiss, M. G., Desai, A., Jadhav, S., et al (1988) Humoral concepts of mental illness in India. Social Science and Medicine, 27, 471–477.Google Scholar
Weiss, M. G., & Kleinman, A. K. (1988) Depression in cross-cultural perspective: developing a culturally informed model. In Psychology, Culture and Health: Towards Application (eds Dasen, P., Sartorius, N. & Berry, J.), pp. 179–206. Beverly Hills: Sage.Google Scholar
Westermeyer, J. (1985) Psychiatric diagnosis across cultural boundaries. American Journal of Psychiatry, 142, 798–805.Google Scholar
World Health Organization (1982) Epidemiology of Leprosy in Relation to Control. Technical Report Series, No. 716. Geneva: WHO.Google Scholar
World Health Organization (1985) Chemotherapy of Leprosy for Control Programmes. Technical Report Series, No. 675. Geneva: WHO.Google Scholar
Williams, J. B. (1988) A structured interview guide for the Hamilton Depression Rating Scale. Archives of General Psychiatry, 45, 742–747.Google Scholar
Wise, T. N. & Freyberger, H. (1983) Consultation-Liaison Throughout the World. Advances in Psychosomatic Medicine, vol. 11. Basel: S. Karger.Google Scholar
Zwick, R. (1988) Another look at interrater agreement. Psychological Bulletin, 103, 374–378.Google Scholar
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