Do they see dead people? Cultural factors and sensitivity in screening for schizophrenia spectrum disorders

Objective. Schizophrenia spectrum disorders (SSDs), are diagnosed more frequently among African-Americans (AAs) than Caucasians. It has been suggested that cultural differences in symptom presentation and endorsement (including reporting spiritual/religious experiences) may influence this disparity. The current study investigated the relationship between endorsement of spiritual auditory and visual hallucinations and subsequent diagnosis of SSD among AA patients.

Design. Participants (N = 471 AAs) completed the Mini International Neuropsychiatric Interview-Plus (MINI-Plus) Screening Interview as part of their intake to a HIV outpatient clinic. Endorsement of auditory or visual (A/V) hallucinations was explored with the MINI-Plus Psychotic Disorder Module and questions regarding the content of the unusual experience.

Results. Logistic regression indicated that endorsement of A/V hallucinations significantly predicted a SSD (OR = 41.6, 95% CI 13.7-126.0, p < .001). However, when hallucinations were spiritual in nature, odds of an SSD fell dramatically (OR = 0.22, 95% CI 0.07-0.64, p < .001).

Conclusions. The current study indicates that not all visual and auditory hallucinations are symptomatic of a psychotic disorder in AA patients. Many of these experiences may be related to spirituality. Clinicians assessing AA patients need to query content of, meaning attributed to, and distress associated with A/V unusual experiences.     

Life in the ‘Anti‐psychiatry’ Fast Lane

This is a personal account of life in the Philadelphia Association from the late 1960s to the 1990s when some of the ideas of Basaglia, Cooper, Deleuze, Esterson, Fanon, Foucault, Guattari, Laing and Szasz were put into practice. Cooper's Psychiatry and Anti‐psychiatry ( 1967 ) was the inspiration for what appeared as an international movement within psychiatry, influenced, among other things, by Foucault's Madness and Civilization ( 1967 ). Szasz believed mental illness to be a myth created by society; Cooper believed that the family was an instrument of oppression perpetrating psychological violence on its members; Laing believed that if one studied the specific forms of communication within families of schizophrenics one could make madness intelligible and therefore amenable to some form of psychotherapy. The paper highlights the evolving understanding of psychosis within the Philadelphia Association and the relationship of psychosis to psychoanalysis. It suggests that far from being a misguided blip in the history of psychiatry, ‘anti‐psychiatry’ could be seen as having revolutionized our discourse in relation to psychosis in a way which has left a worthy and lasting legacy, linking treatment to how we treat one another.     

讷于言而敏于行——儒家思想及其现实意义

儒家思想作为中国悠久传统文化的渊源之一,仁、义、礼、智、信等核心价值观仍然是我们重要的精神资源.其影响力经历数千年锤炼,仍然经久不息,与时俱进.通过对儒家思想的深入研究和探讨,搜集并整理古代文献,并结合当今的社会环境,探讨其对现今社会以及人际关系的现实影响.并提供了一系列的指导性观念和原则,还对社会和谐以及人与人之间的和谐具有指导意义.     

Spiritual Experiences of Adults With Advanced Cancer in Outpatient Clinical Settings

Context

Adults who have advanced cancer experience distress, and many use religion and spirituality to cope. Research on the spiritual experiences of patients with advanced cancer will help guide the provision of high-quality spiritual care.

National Consensus Project’s Clinical Practice Guidelines for Quality Palliative Care,Fourth Edition: Why is This Important to Chaplains?

The Clinical Practice Guidelines for Quality Palliative Care, fourth edition were recently published. Through the involvement of the Association of Professional Chaplains and the HealthCare Chaplaincy Network, this is the first time that any chaplains have been an official party to the development of these guidelines. The expectation set by the guidelines is that all health care professionals (including all chaplains) caring for people living with serious illness at any stage of illness, at any age, and in any setting will integrate core palliative care principles and best practices into their routine care and have sufficient training to complete an assessment of the patient and address common sources of suffering. The article presents a summary of the content of the guidelines and their implications for clinical practice and training with emphasis on the practice and training of professional chaplains.     

Spiritual crisis: a concept analysis

Title.  Spiritual crisis: a concept analysis.
Aim.  This paper is a report of an analysis of the concept of spiritual crisis.
Background.  The term spiritual crisis has been used ambiguously in the literature, resulting in lack of clarity. A holistic approach includes spirituality in nursing care of the whole person.
Data sources.  Papers available online between 1998 and 2007 in the CINAHL, Medline and PsycInfo databases were retrieved for analysis. The search engine Google was also used to examine additional references to 'spiritual crisis'.
Review methods.  Spiritual crisis, spiritual emergency and life crisis were the terms initially used to search each database. The search was expanded to include spirituality to draw more literature into the review.
Findings.  Using Walker and Avant's method of concept analysis, a definition of spiritual crisis was identified. Spiritual crisis can be described as a unique form of grieving or loss, marked by a profound questioning of or lack of meaning in life, in which an individual or community reaches a turning point, leading to a significant alteration in the way life is viewed. Possible antecedents include sudden acute illness and loss of important relationships. Potential consequences may include physical and emotional responses.
Conclusion.  People with terminal illness, depression, and those who are grieving losses may be at special risk of spiritual crisis. The literature suggests an interdisciplinary approach, nurses' self-exploration of spirituality, and refraining from defining spirituality by religious affiliation as part of improving practice.