This study is an ethnographic investigation of sociocultural factors associated with the course of chronic mental disorder. The study is a two by two longitudinal comparison between ethnic (Puerto Rican and Irish- American) and between diagnostic (schizophrenia and depression) groups. A total N of 80 will be analyzed in four analytic cells of 20 patients each. Patients """"""""key relatives"""""""" will also be recruited as study subjects. The study will examine the relation between selected sociocultural factors and indices of chronicity over a two year period. Principal data collection points are at intake, one year, and two years, with telephone contacts at three month intervals to collect abbreviated data and maintain research rapport. The sociocultural factors selected for investigation are (1) expressed emotion; (2) family burden; (3) explanatory models; and (4) life events and difficulties. The indices of chronicity to be observed are: (1) severity of symptoms; (2) work functioning; (3) social functioning. The research is principally ethnographic, based on semi-structured open ended interviews conducted in family settings. Qualitative analysis will focus on a culturally contextualized account of the illness. A four step analytic strategy will include thematic coding of ethnographic data, preparation of case studies and course of illness categories, elaboration of typologies of expressed emotion, and examination of qualitative hypotheses. A quantitative component will focus on measurement and analysis of relations among discrete variables. The three step quantitative analysis will include testing a series of hypotheses concerning the ethnic and diagnostic specificity of sociocultural variables, the relation among sociocultural variables, and the relation between sociocultural variables and indices of chronicity. A variety of ways are specified in which qualitative and quantitative analyses will be complementary. The final product of this contextual, comparative and longitudinal analysis will be an overall ethnographic account of family experience of chronic psychiatric illness, holistically constructed from the various sources of qualitative and quantitative data. The analysis will contribute toward the development of more precise hypotheses to be tested in future research, specifying links between particular sociocultural and clinical variables relevant to the course of established mental illness.
| Coelho, V L; Strauss, M E; Jenkins, J H (1998) Expression of symptomatic distress by Puerto Rican and Euro-American patients with depression and schizophrenia. J Nerv Ment Dis 186:477-83 |
| Jenkins, J H; Cofresi, N (1998) The sociosomatic course of depression and trauma: a cultural analysis of suffering and resilience in the life of a Puerto Rican woman [see comment] Psychosom Med 60:439-47 |
| Jenkins, J H (1997) Subjective experience of persistent schizophrenia and depression among US Latinos and Euro-Americans. Br J Psychiatry 171:20-5 |
