Bibliography: leaves 390-409. / vii, 409, 14, 12 leaves, [3] leaves of plates : col. ill. ; 30 cm. / Title page, contents and abstract only. The complete thesis in print form is available from the University Library. / Concerned with how fifty people diagnosed with schizophrenia invested their world with meaning, utilizing the resources which were available to them in their daily lives. "Extraordinariness" which has its basis in personal experience, is elaborated and multiplied by the social conditions and institutional structures of people's everyday lives. As a consequence of their placement within a field of deinstitutionalized psychiatric services, participants continually traversed the border between their own extraordinary experiences (which highlighted their distinctiveness) and those experiences which were taken for granted by themselves as well as others (and which allowed them to lay an equal claim to ordinariness). In this context, schizophrenia serves as a particularly apt case study in the limits and possibilities of intersubjectivity which is explored as the capacity to render experience meaningful to both self and others. / Thesis (Ph.D.)--University of Adelaide, Depts. of Anthropology and Psychiatry, 1999

Bibliography: leaves 390-409. / vii, 409, 14, 12 leaves, [3] leaves of plates : col. ill. ; 30 cm. / Title page, contents and abstract only. The complete thesis in print form is available from the University Library. / Concerned with how fifty people diagnosed with schizophrenia invested their world with meaning, utilizing the resources which were available to them in their daily lives. "Extraordinariness" which has its basis in personal experience, is elaborated and multiplied by the social conditions and institutional structures of people's everyday lives. As a consequence of their placement within a field of deinstitutionalized psychiatric services, participants continually traversed the border between their own extraordinary experiences (which highlighted their distinctiveness) and those experiences which were taken for granted by themselves as well as others (and which allowed them to lay an equal claim to ordinariness). In this context, schizophrenia serves as a particularly apt case study in the limits and possibilities of intersubjectivity which is explored as the capacity to render experience meaningful to both self and others. / Thesis (Ph.D.)--University of Adelaide, Depts. of Anthropology and Psychiatry, 1999

Among the Xhosas, the healing sickness called intwaso is interptreted as a call by the ancestors to become a healer. Transpersonalists also see these initiatory illnesses as spiritual crises, while according to the widely accepted Western psychiatric view, illness is purely perceived in physical and psychological terms. A case study was conducted where a single participant who has undergone the process of ukuthwasa and is functioning as a traditional healer was interviewed. A series of interviews were done where information was gathered about significant experiences related to ukuthwasa process. Tapes were transcribed and a case narrative was written and interpreted using the traditional Xhosa beliefs, the western psychiatric and the transpersonal psychology perspectives. Strengths and weaknesses of each perspective were then examined.

Observation of the frequency with which major decisions on issues affecting psychiatric patients were decided on material elicited from techniques like the Rorschach stimulated the investigation of the applicability of this technique to African patients. The nosological group chosen for this study was the schizophrenic group. Scrutiny into the literature revealed great diversity in conceptions of the etiology of the schizophrenic condition. To handle this material it was necessary to adopt a modification of the framework used in Friedman and Kaplan (1974). Having gone into the models on etiology it was evident that consistency was only possible in the realm of symptoms and diagnosis and the definition of schizophrenia as a group of psychotic disorders characterised by gross distortions of reality : the disorganisation and fragmentation of perception, thought and emotion and withdrawal from social interaction, was adopted. With this preconceived idea of schizophrenia three hypotheses were formulated to test the diagnostic utility of the Rorschach with Nguni schizophrenic female subjects. Summary, p. 104.

The impact of the emotional climate in the home of the schizophrenic on relapse has been researched extensively through the construct of Expressed Emotion (EE). Most often patients from high EE homes have a higher relapse rate than those from low EE homes. This is a robust finding throughout many western and some non-western countries. However, no published research documents EE status and relapse in African countries. This study reports on the EE status and rehospitalisation rates of 29 Zulu-speaking schizophrenic patients in a South African sample. EE was assessed using a translated version of the Level of Expressed Emotion (LEE) scale, a 60 - item, self-report measure developed in Canada (Cole & Kazarian, 1988). A multistage translation procedure, comprising back-translation, the committee approach and decentering was employed. The Zulu SCL-90-R was administered as an indicator of psychological distress. Follow-up data on rehospitalisation was collected nine months after index admission. Results indicated somewhat unsatisfactory internal reliabilities on some of the subscales of the Zulu LEE scale. High scores on the Zulu LEE scale were not significantly predictive of rehospitalisation at follow-up; however, they were significantly predictive of greater previous admissions. The psychometric properties of the Zulu SCL-90-R were found to be satisfactory, indicating the validity of using this instrument for the purpose of screening for psychiatric illness. Zulu schizophrenics were found to have a lower rehospitalisation rate (17% at nine month follow-up) than found in international studies. The course for female schizophrenics was better than that for male schizophrenics. Findings are inconclusive regarding the impact of EE on the course of schizophrenia in a Zulu sample. / Thesis (M.Soc.Sc.)-University of Natal, Pietermaritzburg, 2000.

Indiana University-Purdue University Indianapolis (IUPUI) / This study investigates differences between Veterans and non-Veterans with severe mental illness (SMI) regarding perceptions of their illness, themselves, and treatment. I compare patient interviews (using the Indiana Psychiatric Illness Interview, IPII) of Veterans (N=20) and non-Veterans (N=26). Modified grounded theory and qualitative coding software Atlas-TI were used to develop codebooks for each group, and these were compared for differences. I examined differences in both code frequency and meaning. Statistically, more Veterans were male, employed, married, had higher income, and had higher education. Statistical differences in code frequency included: more Veterans discussing boredom, regret/guilt/loss, and wanting to be “normal.” More non-Veterans had codes of pessimism and religion/spirituality, wanting a different future, bringing up mental health, family, future: no change, life goals, and relapse. Key differences in narrative themes included: (1) Veterans’ “military mindset”/discussion of anger as part of mental illness, (2) non-Veterans’ focus on mental-illness, (3) differing attitudes regarding stigma, (4) active versus passive attitudes toward treatment, and (5) degree of optimism regarding the future. Differences are described and then potential relationships and interactions are proposed. Veterans appear to have several protective factors (i.e., finances, employment, marriage). Additionally, Veterans’ military-mindset seems to encourage greater stigma-resistance, and thereby also facilitate Veterans being more active and optimistic toward treatment and recovery. By contrast, non-Veteran focus on mental illness may be related to increased self-stigma, passive and pessimistic attitudes. I propose that Veteran identity can serve as an additional protective factor against stigma, pessimism, and passivity. Veteran-identity may also be a useful framework clinically, to help promote active approaches to treatment (e.g., “fighting symptoms”). Further, Veterans emphasized issues relating to anger as important and part of their mental health. It may be that Veterans are more comfortable discussing mental health in the language of “anger,” given stigma. Finally, findings suggest that helping individuals in both groups engage in meaningful, non-mental illness-related life activities may help shape self-perception, and thereby responses to stigma, attitudes toward treatment, and hope for the future.