Classification of natural and supernatural causes of mental distress. Development of a Mental Distress Explanatory Model Questionnaire.

This paper describes the background and development of a Mental Distress Explanatory Model Questionnaire designed to explore how people from different cultures explain mental distress. A 45-item questionnaire was developed with items derived from the Murdock et al. categories, with additional items covering western notions of physiological causation and stress. The questionnaire was administered to 261 people, mostly college students. Multi-dimensional scaling analysis shows four clusters of mental distress: a) stress; b) western physiological; c) nonwestern physiological; and d) supernatural. These clusters form two dimensions: western physiological vs. supernatural and impersonal vs. personalistic explanations. Natural and stress items are separated from supernatural and nonwestern physiological items along the first dimension. Brain damage, physical illness, and genetic defects have the greatest separation along the first dimension. Being hot, the body being out of balance, and wind currents passing through the body most strongly represent the non-western physiological category. The questionnaire has the potential to be used for community health screening and for monitoring patient care, as well as with students in the health sciences and with health practitioners.