Causal attribution for mental illness in Cuba: A thematic analysis

Area of Science:

• Medical Anthropology
• Cultural Psychiatry
• Qualitative Health Research

Background:

• Explanatory models (EMs) of illness are crucial for patient understanding, clinical diagnosis, and treatment.
• Research on EMs predominantly focuses on Western cultures, leaving a gap in understanding non-Western perspectives.
• Cultural context significantly shapes personal illness narratives and causal attributions.

Purpose of the Study:

• To investigate local causal attributions for mental illness within the unique socio-political context of Cuba.
• To explore how Cuban culture influences patients' understanding of the causes of their mental illness.
• To identify specific patterns of causal attribution for mental illness in the Cuban population.

Main Methods:

• Qualitative study employing semi-structured interviews with 14 psychiatric patients in Havana.
• Interviews based on the Clinical Ethnographic Interview framework.
• Thematic analysis used to identify recurring patterns in causal attributions.

Main Results:

• Six distinct patterns of causal attribution for mental illness were identified.
• These include personal shortcomings, family influences, excessive demands, the Cuban socio-political environment, physical causes, and symptom-related explanations.
• Cuba-specific attributions frequently located the causes of mental illness externally, differing from some Western models.

Conclusions:

• Cuban patients' attributions for mental illness are shaped by both general and culture-specific factors.
• External attributions may be linked to Cuban socio-centric orientation, familismo, and socialist societal experiences.
• Findings offer insights into social stigma and help-seeking behaviors within the Cuban context.