The phenomenon of acculturation stress is described with particular reference to the subsequent development of the transitional role conflict. The adolescent and young adult male Eskimo is especially susceptible to the anxiety generated by the process of acculturation and it is the interaction of this external stress with the bio-psychosocial characteristics of the individual within his ecological group, that may lead to an increased incidence of mental disorder. The clinical picture that develops will depend on the complex interaction of this psychosocial stressor and the level of ego development and its accompanying defence and coping strategies. We see how the development of manifest psychopathology in two young Inuit males was intimately associated with the stresses of acculturation acting upon personalities characterized by a low self-esteem and negative self-image, feelings of emasculation and a state of anomie. Coping and defensive strategies exhibited both similarities (drugs, alcohol, withdrawal, actin out) and differences (psychosis versus dissociation). The value of modified supportive therapy with continuity of care aimed at increasing self-esteem through sublimation, identification, reduction of dependency and encouragement of growth and autonomy is described, as are measures aimed at primary prevention.
From: Fortuine, Robert et al. 1993. The Health of the Inuit of North America: A Bibliography from the Earliest Times through 1990. University of Alaska Anchorage. Citation number 2319.
It has been my great fortune to have spent this past summer traveling across North America with my husband. We left our home state of New Hampshire in June and, in late July, arrived in the 49th state, Alaska, where we have settled in for the winter. From Manitoulin Island and the shores of Lake Huron to the Black Hills of South Dakota and on through the Canadian Rockies, we traveled through a number of North American Native communities. It is this experience and my recent introduction to Alaskan Native culture and peoples that are the impetus for this feature, where I will explore the historical and re-emerging use of art to promote health and healing in Native communities.
Although Alaska has one of the highest rates of alcohol consumption in the U.S., there are very few reports of other drug use in Alaska. This five-year NIDA-funded study sampled out-of-treatment injection drug users (IDUs) and crack cocaine smokers in Anchorage, Alaska. This paper is a summary of results comparing risk behavior for HIV and sexually transmitted disease infection among Alaska Natives (n=216) to non-Natives (primarily Blacks n=394 and Whites n=479) from this study. IDUs and crack cocaine smokers were recruited using a targeted sampling plan. All subjects tested positive to cocaine metabolites, or morphine, using urinalysis, or had visible track marks. Several analyses of this database have indicated that Alaska Native women are at high risk for gonorrhea infection. They are also at risk for HIV infection due to high rates of behavior related to blood-borne disease transmission. We have also found that White men who have sex with both White and Alaska Native women are significantly less likely to use condoms with the Alaska Native women. HIV preventive education efforts aimed at Alaska Native women need to be implemented on a major scale.
Suicide rates in Alaska Native elders are studied to further explore cultural factors in elderly suicide. Data for the 1960s and 1970s are reviewed, and new data on Alaska Native suicide rates are presented for the 10-year period of 1985 through 1994. In many areas throughout the world, suicide rates are the highest for the elderly. During the Alaska "oil boom," suicide rates more than tripled for the general population but decreased to zero for Alaska Native elders. Cultural teachings from the society's elders were more important during this time of culture upheaval. During the study period, the cultural changes dissipated, and suicide rates for Alaska Native elders, although lower than those of White Alaskans, increased. This provides further evidence that suicide rates for elders can be influenced by social factors--both to raise to lower rates.
Quantitative alcohol interviews conducted as part of the National Institute on Drug Abuse (NIDA) Native American Supplement revealed very high rates of alcohol use among American Indian and Alaska Native active crack and injection drug users (IDUs). Of 147 respondents who completed the alcohol questionnaire, 100& percent had drunk alcohol within the past month, almost 42& percent reported that they drank every day, and 50& percent drank until they were drunk one-half of the time or more. Injection drug users (IDUs) demonstrated the highest frequency and quantity of alcohol use in the past 30 days. A significant positive association was also found between crack and alcohol use in the past 48 hours (c(2)=5.30, p
Migration of the native populations from reservations to the urban areas has resulted in mixed ethnicities of American Indian/Alaskan Native (AIAN) children. Minority youth require special attention and services in urban schools as they disproportionately experience poverty, low educational attainment, unemployment, and single-parent status.
We used 2005 and 2007 Youth Risk Behavior Survey data to examine alcohol/drug use patterns and their association with sexual risk taking among AIAN only (single-racial) and biracial youth in combination with White, African American, or Hispanic ethnicities (N = 1178).
Overall, one half of the students were sexually active, with significantly higher rates among males; AIAN-Black students initiated sex earlier than the other groups. Condom nonuse is higher among AIAN-Whites (>50%) compared to one third of AIAN-Hispanics and one fourth of AIAN-Blacks. Nearly 10% of all students, except AIAN-Blacks, reported lifetime use of heroin/meth. Sexual behavior was significantly associated with episodic drinking. Students with Hispanic background have twice the odds of being sexually active compared to AIANs.
Our findings underscore growing health care needs and targeted prevention initiatives for mixed racial underserved native youth. Urban school settings have potential to deliver services and offer alcohol/drug prevention programs to address the needs of mixed racial native urban youth. Using the School Based Health Clinic model has been successful; we need to reform prevention approaches to accommodate needs of multiracial urban native youth.
In this Alaska Native study, cultural "insiders" analyzed problems associated with increased alcohol availability, factors which have reduced alcohol-related problems, and ideas for improving treatment in an Inuit community. Participants described frequent binging, blackouts, family violence, suicide, loss of child custody, and feelings of intergenerational grief. Helpful existing treatment approaches include alcohol ordinances, inpatient treatment programs, twelve-step groups, and religious involvement. Participants urged the development of family treatment approaches which integrate Inuit customs and values.
The study was conducted to determine if alpha brain-wave neurofeedback training can have positive psychological results by reducing anxiety and other psychopathology.
The cohort participated in alpha brain-wave neurofeedback training for 76 minutes (day 1) to 120 or more minutes (days 5-7) daily for 7 days. Electroencephalogram (EEG) electrodes were attached to the head with conductive gel according to the 10-20 International Electrode Placement System. During training, participants were seated in a comfortable armchair within a soundproof and lightproof room. Brain-wave signals were amplified for processing by analog-to-digital converters and polygraphs, then filtered to the pure delta, theta, alpha, beta, and gamma bands as well as subbands of these bands of the EEG. For 2-minute epochs, trainees sat with their eyes closed in the dark listening to their feedback tones as the filtered alpha brain-wave EEG signals controlled the loudness of the tones. Then a "ding" sounded and the tones stopped. For 8 seconds, a monitor lit up with dimly illuminated, static numbers, indicating the strength of their alpha brain waves, after which the feedback tones resumed and the process was repeated.
40 adult volunteers were recruited from the aboriginal population (First Nations, Métis, and Inuit) of Canada. The cohort ranged in age from 25 to 60 years and included males and females.
The study was conducted at Biocybernaut Institute of Canada in Victoria, British Columbia.
Data was obtained to determine the effectiveness of this training by giving four psychological tests (Minnesota Multi-Phasic Personality Inventory, and the trait forms of the Multiple Affect Adjective Check List, Clyde Mood Scale, and Profile of Mood States) on the first day prior to commencing training and on the seventh day upon completion of the training. EEG data was also compiled throughout the training and analyzed as a factor of the training process.
Postintervention data showed positive results with reduction of psychopathology when compared to the data from testing prior to the training. Analysis of this data showed improvement in several areas of psychopathology.
Alpha brain-wave neurofeedback training daily for 7 days does have positive psychological results in adult male and female Canadian aboriginals as measured by data from four psychological tests on the participants.
Implementation of Evidence-Based Practices (EBP) within American Indian and Alaskan Natives communities is currently an area of debate and contention. There is considerable concern about expanding EBP policy mandates to AI/AN communities as these mandates, either through funding restrictions or other de facto policies, recall past histories of clinical colonization and exploitation by the state and federal government. As a response, work is being done to evaluate indigenous programs and examine strategies for culturally-sensitive implementation. While the literature reflects the perspectives of AI/AN populations on EBP generally, no one has yet reported the perspectives of AI/AN communities on how to feasibly achieve widespread EBP implementation. We report the findings of a statewide Tribal Gathering focused on behavioral health interventions for youth. The Gathering participants included AI/AN individuals as well as staff working with AI/AN populations in tribal communities. Participants identified strengths and weaknesses of the five legislatively fundable programs for youth delinquency in Washington State and discussed strategies likely to be effective in promoting increased uptake within tribes. Analysis of these discussions resulted in many useful insights in program-specific and community-driven strategies for implementation. In addition, two major themes emerged regarding widespread uptake: the importance of a multi-phase engagement strategy and adopting a consortium/learning community model for implementation. The findings from this Gathering offer important lessons that can inform current work regarding strategies to achieve a balance of program fidelity and cultural-alignment. Attending to engagement practices at the governance, community and individual level are likely to be key components of tribal-focused implementation. Further, efforts to embed implementation within a consortium or learning community hold considerable promise as a strategy for sustainability.
BACKGROUND: Antenatal depression is potentially deleterious to the mother and baby. Canadian Aboriginal women have an increased risk for living in poverty, family violence, and substance use; however, little is known about antenatal depression in this group. The aim of this study was to determine the prevalence and correlates of depression in socially high-risk, mostly Aboriginal pregnant women. METHODS: Women (Aboriginal and non-Aboriginal), in two prenatal outreach programmes were approached and depressive symptoms between the two groups were compared, using the Edinburgh Postnatal Depression Scale (EPDS). RESULTS: Sixty per cent (n = 402) of potential participants were recruited for the study. The prevalence of depression was 29.5% (n = 402). Depression was associated with a history of depression, mood swings, increased stressors, current smoker, and lack of social support. Aboriginal women were more likely to be depressed, but this was not significantly higher than non-Aboriginal women; however, they did experience significantly more self-harm thoughts. Exercise was a significant mediator for depression. CONCLUSION: The prevalence of antenatal depression confirms rates in other high-risk, ethnic minority groups of women. A previous history of depression and mood problems were associated with depression, thus prenatal care should include a careful mental health assessment. On a positive note, the present study suggests that exercise may mediate antenatal depression.