Papers by Meryam Schouler-Ocak
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Hella von Unger (Prof. Dr.) ist Professorin für Soziologie mit dem Schwerpunkt Qualitative Method... more Hella von Unger (Prof. Dr.) ist Professorin für Soziologie mit dem Schwerpunkt Qualitative Methoden der Sozialforschung an der Ludwig-Maximilians-Universität München. Ihre Arbeitsschwerpunkte sind Migration und Gesundheit, Forschungsethik und partizipative Methoden. Helen Baykara-Krumme ist Professorin für Soziologie mit dem Schwerpunkt Migration und Teilhabe an der Universität Duisburg-Essen. Ihre Forschungsschwerpunkte umfassen Migration und Transnationalisierung, Integration und Teilhabe sowie familiale Prozesse und Familienbeziehungen im Migrationskontext. Serhat Karakayali ist Professor für Soziologie mit dem Schwerpunkt Migration und Mobilität an der Leuphana Universität Lüneburg. Er ist zugleich Mitglied des Berliner Instituts für empirische Integrations-und Migrationsforschung an der HU Berlin und wirkt am Nationalen Diskriminierungs-und Rassismusmonitor (DeZIM-Institut) mit. Schwerpunkte seiner Forschung sind die politische Soziologie der Migration, Solidarität in der Migrationsgesellschaft und Rassismusforschung. Karen Schönwälder ist Sozialwissenschaftlerin und Forschungsgruppenleiterin am Max-Planck-Institut zur Erforschung multireligiöser und multiethnischer Gesellschaften. Sie ist zudem außerplanmäßige Professorin an der Georg-August-Universität Göttingen. Sie beschäftigt sich mit den Reaktionen europäischer Gesellschaften auf Migration und Diversität sowie mit deren politischer Gestaltung und Fragen politischer Beteiligung und Repräsentation.
Person Centered Approach to Recovery in Medicine, 2018
Migrants and ethnic minorities are at higher risk to develop mental disorders compared to native ... more Migrants and ethnic minorities are at higher risk to develop mental disorders compared to native population. Culture has an important impact on the symptom presentation, diagnostic process and treatment strategies in all populations. Cultural competence represents good clinical practice and can be defined as a two-way learning encounter where clinician acknowledges the patient’s culture as well as his own cultural values and prejudices. Cultural competent response to the mental health care requires knowledge, skills and attitudes. Both individual and organizational cultural competences are needed to improve the effectiveness of psychiatric treatment. In this chapter, we revised the WPA Guidance on Mental Health and Mental Health Care for Migrants and the EPA Guidance on Mental Health Care for Migrants and list a series of recommendations for policy-makers, service providers and clinicians. Cultural competent experiences in the treatment of somatization and other psychiatric disorder...
In verschiedenen Studien konnte ein höheres Risiko für das Vorliegen psychischer Beschwerden wie ... more In verschiedenen Studien konnte ein höheres Risiko für das Vorliegen psychischer Beschwerden wie Depression, Ängstlichkeit oder ein erhöhtes Suizidrisiko bei Menschen mit Migrationshintergrund aufgezeigt werden (Hovey & Magaña, 2000; Merbach et al., 2008). In Deutschland existierte bislang wenig Forschung, die sich mit psychischen Störungen und deren Behandlung bei Menschen mit Migrationshintergrund befasste. Vorliegende Zahlen aus unterschiedlichen Versorgungsregionen wiesen darauf hin, dass Migranten von Teilen der psychiatrischen Versorgung oft nur unzureichend erreicht bzw. über- sowie unterversorgt wurden. Vor diesem Hintergrund war unser Ziel, Daten zur aktuellen Versorgungssituation bezüglich der Inanspruchnahme der stationären – psychiatrischen und der ambulanten in Psychiatrischen Institutsambulanzen in den Einrichtungen der Psychiatrie und Psychotherapie durch Menschen mit Migrationshintergrund zu erheben. Zugleich untersuchten wir die Häufigkeitsverteilungen der diagnostischen Zuordnungen bei diesen Patienten. Migranten im stationären Bereich erhielten im Vergleich zu einheimischen Patienten mehr diagnostische Zuordnungen aus dem Spektrum der F2 - Diagnosen. Im ambulanten Bereich waren Erkrankungen aus dem Affektiven Bereich häufiger. Unsere Untersuchungen wiesen darauf hin, dass die Inanspruchnahme der psychiatrischen Versorgung durch Patienten mit Migrationshintergrund in stationären und ambulanten Bereichen unterschiedlich ist. Während die Migranten im stationären - psychiatrischen Bereich im Durchschnitt entsprechend ihrem Bevölkerungsanteil repräsentiert sind, sind sie in Psychiatrischen Institutsambulanzen überrepräsentiert. Bezüglich der Prävalenz der Depression bei älteren Migranten wurde festgestellt, dass bei Menschen mit Migrationshintergrund im Alter von 50 Jahren und älter eine erhöhte Prävalenz für Depression im Vergleich zu gleichaltrigen Einheimischen bestand. Depression gilt auch als Risikofaktor für dementielle Erkrankungen, so dass diese Erkenntnisse auch diesbezüglich Bedeutung [...]
Frontiers in Psychology, 2020
Recent research has identified significant correlations between traumatic events and depression i... more Recent research has identified significant correlations between traumatic events and depression in refugees. However, few studies have addressed the role of acculturation strategies in this relationship. This study explored the relationship between cultural orientation, traumatic events and depression in female refugees from Syria, Afghanistan, Eritrea, Iran, Iraq, and Somalia living in Germany. We expected acculturation strategies to moderate the effect of traumatic experiences on depression. The sample included 98 female refugees in Germany. The depression scale of the Hopkins Symptom Checklist (HSCL) represented the dependent measure. The trauma checklists derived from the Post-traumatic Diagnostic Scale (PDS) and the Harvard Trauma Questionnaire (HTQ) as well as the Frankfurt Acculturation Scale (FRACC) were used as independent measures for traumatic events and orientation toward the host culture as well as orientation toward the culture of origin, respectively. A moderation analysis was conducted to examine whether the relationship between the number of traumatic events and depression was influenced by the women's orientation toward the culture of origin and the host culture. We identified a significant model explaining 26.85% of the variance in depressive symptoms (Cohen's f 2 = 0.37). The number of traumatic events and the orientation toward the host culture exerted significant effects on depressive symptoms. The moderating effect was not significant, indicating that the effect of the number of traumatic events was not influenced by cultural orientation. Based on our results, orientation toward the host culture as well as traumatic experiences exert independent effects on depressive symptoms in refugees.
InFo Neurologie & Psychiatrie, 2018
Als ich das Konzept der Transkulturalität vor einigen Jahren ausarbeitete, ging ich von einer ein... more Als ich das Konzept der Transkulturalität vor einigen Jahren ausarbeitete, ging ich von einer einfachen Frage aus. 1 Ich hatte den Eindruck, daß unsere gängigen Kulturbegriffe auf ihren Gegenstand, die heutigen Kulturen, nicht mehr passen. Umgekehrt gesagt: Unsere Kulturen scheinen mir heute eine Verfassung aufzuweisen, die anders ist, als unsere Kulturbegriffe sie behaupten oder suggerieren. Sollte dies zutreffen, so käme es darauf an, diese Begriffe zu verändern, eine neue Konzeptualisierung von Kultur zu erarbeiten. Nicht jedermann hält diese Konsequenz für angezeigt. Manche Kulturphilosophen halten lieber weiterhin an ihren gewohnten Begriffen fest und sagen, wenn die Wirklichkeit diesen sich nicht fügt: "umso schlimmer für die Wirklichkeit". Ich schlage den umgekehrten Weg ein. Ich suche einen Kulturbegriff, der deskriptiv der Verfassung unserer heutigen Kulturen angemessen ist und der darüber hinaus auch den normativen Erfordernissen der Gegenwart Rechnung zu tragen vermag.
BMC Psychiatry, 2019
Background: Prolonged Grief Disorder (PGD) is a distinct syndrome that follows bereavement. It is... more Background: Prolonged Grief Disorder (PGD) is a distinct syndrome that follows bereavement. It is different from other mental disorders and is characterized by symptoms such as yearning for the bereaved, or intense emotional pain or distress. Violent loss is one major risk factor for the development of PGD. Objectives: PGD has been studied in different populations, mostly in small samples, with only a few of them being representative. Although research highlighted that traumatic experiences paired with challenges related to migration make refugees particularly vulnerable to PGD, PGD has only rarely been studied in refugees. Thus, this article a) examines the prevalence of PGD in female refugees in Germany according to the criteria proposed by Prigerson and colleagues in 2009, and b) associates PGD with other common psychopathology (e.g. anxiety, depression, somatization and trauma). Method: A total of 106 female refugees were assessed for bereavement and PGD. Of these 106 individuals, 85 were interviewed using the Prolonged Grief Disorder Scale (PG-13). Symptoms of anxiety and depression were assessed by the Hopkins Symptom Checklist-25 (HSCL-25), somatization was assessed by the Somatization Subscale of the Symptom-Checklist-90 (SCL-90), and the number of witnessed and experienced trauma was assessed by the Posttraumatic Diagnostic Scale (PDS/HTQ). Results: Ninety of the 106 participants had experienced bereavement, and among those, 9.41% met criteria for PGD. The most frequent PGD symptoms were bitterness, longing or yearning for the bereaved, and lack of acceptance of the loss. Furthermore, grief symptoms were significantly associated with symptoms of depression, anxiety, somatization, and the number of experienced traumatic events. Conclusion: The PGD prevalence rate found corresponds with previous studies, demonstrating that prevalence rates for PGD are especially high in refugees. High prevalence rates of bereavement as well as PGD highlight the need for assessment and specifically tailored treatment of PGD in refugees. PGD goes along with significant psychopathology, which further emphasizes the need for treatment.
DNP - Der Neurologe & Psychiater, 2017
Das medizinische Versorgungssystem in Deutschland war auf die Behandlung von Patienten mit Migrat... more Das medizinische Versorgungssystem in Deutschland war auf die Behandlung von Patienten mit Migrationshintergrund nicht eingestellt und wurde durch die hohe Zahl geflüchteter Menschen mit einer Traumafolgestörung überrascht. Die interkulturelle Behandlung stellt den Regelfall dar. Allerdings fehlen noch immer qualifizierte Sprach- und Kulturmittler sowie interkulturell kompetente Behandler in ausreichender Zahl.
Psychotherapeut, 2017
ZusammenfassungBei Patienten mit Fluchthintergrund, die keine oder geringe Deutschkenntnisse aufw... more ZusammenfassungBei Patienten mit Fluchthintergrund, die keine oder geringe Deutschkenntnisse aufweisen, ist die interkulturelle traumazentrierte Psychotherapie mit einem Kultur- und Sprachmittler genauso wirksam wie muttersprachliche traumazentrierte Psychotherapie zu zweit. Da eine muttersprachliche traumazentrierte Psychotherapie i. Allg. an der geringen Anzahl qualifizierter Therapeuten scheitert, gehört die interkulturelle traumazentrierte Psychotherapie zu dritt zum Regelfall, auch bei spezifischen Therapieformen wie z. B. der Eye-Movement-Desensitization and Reprocessing (EMDR)-Methode im Rahmen der Behandlung von Patienten mit Fluchthintergrund und einer traumainduzierten Störung wie einer posttraumatischen Belastungsstörung (PTBS). Diese ist ein schulenergänzendes Zusatzverfahren, das zur Auflösung eines traumatischen Ereignisses innerhalb einer Therapie eingesetzt wird. Dieser Beitrag gibt einen Überblick über die EMDR-Methode im Kontext der interkulturellen traumazentrierten Psychotherapie und Hinzuziehung von Sprach- und Kulturvermittlern bei Patienten mit Fluchthintergrund und schließt mit Empfehlungen für dieses Setting ab.AbstractIntercultural trauma-centered psychotherapy with cultural advisors and professional trained interpreters is just as effective as psychotherapy in the native language of refugee and asylum seeker patients without any language competency in German. Trauma-centered psychotherapy in native languages cannot in general be implemented because the number of qualified psychotherapists who speak a native language is insufficient; therefore, working with professionally trained interpreters is of great importance. This setting reduces the barriers to treatment by trauma-centered intercultural psychotherapy with a professionally trained interpreter. Using the Eye Movement Desensitization and Reprocessing method (EMDR) with a professionally trained interpreter is of increasing interest, so that more and more refugee and asylum seeker patients with a trauma-related disorder, e. g. posttraumatic stress syndrome (PTSD) can be treated. The EMDR method is an additional approach, which overlaps with various concepts of psychotherapy. This article gives an overview of intercultural trauma-centered psychotherapy using the EMDR method with a professionally trained interpreter in refugee and asylum seeker patients and concludes with recommendations for this setting.
European Psychiatry, 2017
Global migration and the increasing number of minority groups, including immigrants, asylum seeke... more Global migration and the increasing number of minority groups, including immigrants, asylum seekers, refugees and ethnic minorities, mean that increasingly, psychiatrists and patients may come from different cultural backgrounds. Therefore, cultural differences between patients and clinicians have become a matter of growing importance to mental health care as western societies have become increasingly diverse. This talk will attempt to illustrate how attention to these cultural differences enriches the discussion of ethics in mental health care. This talk will also attempt to underline that cultural competence is able to enhance the ethical treatment of mental health of patients from different cultural backgrounds. Consequently, to be culturally competent, a clinician must be sensitive, knowledgeable, and empathetic about cultural differences. Therefore, cultural competence is a concrete, practical expression of bioethics ideals. According to Hoop et al. in 2008, it is a practical, ...
European Psychiatry, 2017
IntroductionGermany is one of the European countries that receive the highest number of refugees ... more IntroductionGermany is one of the European countries that receive the highest number of refugees for the last years, with around 468 thousand asylum seekers in the first half of 2016. However, the increase in the speed of short-term procedures regarding refugees may at the same time overlook the risks regarding specific populations. Moreover, women and children constitute the most vulnerable groups during war and conflicts and the worst effects, in terms of physical, mental and social consequences, develop on these groups.ObjectivesTo understand deeply the psychosocial situation of female refugees that have arrived in Federal German Republic, to assess their challenges and resources before, during and after the displacement and to propose recommendations for policy changes.MethodsThe study consists of two modules, taking place in five states in Federal German Republic, including Berlin, Mecklenburg-Vorpommern, Bayern, Hessen und Mainz. In the first step, a representative stratified ...
DNP - Der Neurologe und Psychiater, 2015
Bundesgesundheitsblatt - Gesundheitsforschung - Gesundheitsschutz, 2008
For many decades it was assumed that depressive disorders are mainly a problem of Western societi... more For many decades it was assumed that depressive disorders are mainly a problem of Western societies. However, a World Bank report published in 1993 revealed that Major Depression is already the fifth leading contributor to the Global Burden of Disease (GBD) among women in developmentally disadvantaged countries. The core symptoms of depression are disorders of affect, conduct and somatic complaints. In Western societies, the key symptom of depression is regarded to be a disorder of affect. However, in other cultural settings, different symptoms may be more central for depression. Nowadays mental health specialists have regular contact with patients from different cultural backgrounds. In order to achieve optimal results in diagnosing and treating mental disorders, it is important to consider the cultural background of a patient and her or his explanatory model of the disease. Transcultural psychiatry and psychotherapy aims at developing culture-sensitive concepts for treatment and mental health services and tries to increase insight in culture-related psychopathology and epidemiology.
Praxis der Interkulturellen Psychiatrie und Psychotherapie, 2011
Begutachtung bei Menschen Mit Migrationshintergrund, 2013
To act as an expert in forensic psychiatry special competency in juristic problems have to be ava... more To act as an expert in forensic psychiatry special competency in juristic problems have to be available. To prevent misdiagnosis, the way to see it and misallocation to forensic psychiatry cross-cultural communication have to be ensured. Cross-cultural competency of the expert should to be one of the requirements. Different perception of juristic questions should be avoided.
Klinikleitfaden Psychiatrie Psychotherapie, 2013
Netherlands. Her academic interests and scientific publications focus on female immigrants and su... more Netherlands. Her academic interests and scientific publications focus on female immigrants and suicidal behavior as well as suicidal behavior among sexual minority youth, using a sociocultural perspective.
Das Gesundheitswesen, 2009
European Psychiatry, 2012
Even though some studies suggest that in Mediterranean and non-western cultures more somatic and ... more Even though some studies suggest that in Mediterranean and non-western cultures more somatic and less psychological symptoms are reported, this so-called 'somatization' hypothesis has been challenged. Reviews show that somatic symptoms are a core component of depressive episodes regardless of cultural background. The expression of symptoms might be related to the psychosocial, social and cultural context surrounding the patient rather than 'ethnicity' or related constructs. Also, stigma associated with mental disorders can affect patients'symptom presentation. The interrelationships of perceived stigmatization (Explanatory Model Interview Catalogue - Stigma Scale), depression (Beck Depression Index II), overall psychological distress (Symptom Checklist-90-R), and somatic symptoms (The screening for SOMATOFORM SYMPTOMS II) was assessed in a sample of female patients with Turkish descent with a diagnosis of depression (N=63). Depression, overall psychological distress, and somatic symptoms were positively and significantly related. Stigma was positively related to depression and overall psychological distress. There was no significant relationship between stigma and somatic symptoms, neither among the severely depressed group (N=39), nor among the less depressed group (N=24). The positive relationships between stigma, depression, and overall psychological distress indicate that patients who are more depressed and who have higher levels of overall psychological distress experience their condition as more stigmatizing. Since somatic symptoms and stigma were not related (neither positively, nor negatively), it appears that depressive symptoms and other symptoms of psychological distress affect concerns about stigmatizing attitudes in a way that somatic symptoms do not. This result challenges common assumption of the 'somatization'hypothesis, i.e. that depression is 'somatized'because of concern about stigmatizing attitudes.
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Papers by Meryam Schouler-Ocak