: Jamaican soccer, poiesis and post-colonial transformation.

This article presents a case study of an innovative culturally based therapeutic approach using collective poiesis to improve the functioning of a youth sports team in Jamaica. In recent decades, Jamaica has endured high levels of violence and corruption, and has been ranked among the top four countries in the world in terms of murder rate per capita. We conjecture that a high prevalence of personality disorder linked to the legacy of slavery and colonialism often impedes Jamaicans from achieving success in diverse fields, including sports.

Community Engagement Mental Health Model for Home Treatment of Psychosis in Jamaica.

Economic constraints in low- and middle-income countries like Jamaica challenge health care services to identify efficient methods of mental health care. This column describes the community engagement mental health (CEMH) model in Kingston, Jamaica, for patients with mental disorders, including psychosis. The CEMH uses a task sharing methodology to deliver acute psychiatric treatment within a community setting.

Owning our madness: Contributions of Jamaican psychiatry to decolonizing Global Mental Health.

The contentious debate on evidence-based Global Mental Health care is challenged by the primary mental health program of Jamaica. Political independence in 1962 ushered in the postcolonial Jamaican Government and the deinstitutionalization of the country's only mental hospital along with a plethora of mental health public policy innovations. The training locally of mental health professionals catalyzed institutional change.

The ethics of relationality in implementation and evaluation research in global health: reflections from the Dream-A-World program in Kingston, Jamaica.

Background: Despite recent developments aimed at creating international guidelines for ethical global health research, critical disconnections remain between how global health research is conducted in the field and the institutional ethics frameworks intended to guide research practice.

Discussion: In this paper we attempt to map out the ethical tensions likely to arise in global health fieldwork as researchers negotiate the challenges of balancing ethics committees' rules and bureaucracies with actual fieldwork processes in local contexts. Drawing from our research experiences with an implementation and evaluation project in Jamaica, we argue that ethical research is produced through negotiated spaces and reflexivity practices that are centred on relationships between researchers and study participants and which critically examine issues of positionality and power that emerge at multiple levels.

Current research on transcultural psychiatry in the Anglophone Caribbean: epistemological, public policy, and epidemiological challenges.

In this article, we review recent research on mental health in the Caribbean. Three major themes emerge: (a) the effects of colonialism on the Caribbean psyche; (b) decolonization of psychiatric public policy, including innovative treatment approaches, deinstitutionalization, and community and policy responses to mental health issues; and (c) the nature and epidemiology of psychiatric pathology among contemporary Caribbean people, with particular focus on migration, genetic versus social causation of psychosis and personality disorders, and mechanisms of resilience and social capital. Caribbean transcultural psychiatry illustrates the principles of equipoise unique to developing countries that protect the wellness and continued survival of postcolonial Caribbean people.

Promoting Resilience in High-risk Children in Jamaica: A Pilot Study of a Multimodal Intervention.

Objective: To assess the effectiveness of a multimodal afterschool and summer intervention called the Dream-A-World (DAW) Project for a cohort of school-aged Jamaican children from an impoverished, disadvantaged inner-city community in Kingston, Jamaica. Children were selected by their teachers based on severe disruptive disorders and academic underachievement and compared with a matched control group. The pilot was a child focused therapeutic modality without parental intervention for disruptive conduct and academic failure.

Historiographic analysis of the Jamaican 'Shakatani' scotoma from the short stories of Erna Brodber.

Objective: To use historiography in the analysis of the fictional writings of a Jamaican novelist to identify aspects of psychopathology of Jamaican people.

Method: Each of 12 stories of "The World is a High Hill" by novelist Erna Brodber was assigned an explanatory title and a 'psychic centrality'. A narrative qualitative analysis of the fourteen main themes of each story was created using a Lickert scale, calculating the psychopathological penetrance or weighted significance of each theme.

The prevalence of personality disorder in a general medical hospital population in Jamaica.

Objective: To determine the prevalence of personality disorders in patients admitted to the general medical wards of the University Hospital of the West Indies (UHWI).

Method: Patients (n = 100) sequentially admitted to the general medical wards of the UHWI were assessed for the diagnosis of personality disorder using the gold standard of a consultant assessment based on the Diagnostic and Statistical Manual of Mental Disorders, fourth edition, text revision (DSM IV-TR) diagnostic criteria for personality disorder, the International Personality Disorder Examination Screening questionnaire (IPDE-S) and the Jamaica Personality Disorder Inventory (JPDI).

Results: The three assessment instruments identified a prevalence of personality disorder in the cohort of patients of 21% consultant DSM IV-TR assessment, 28% JPDI and 70% IPDE-S.

The prevalence of personality disorder in a psychiatric and substance abuse population in Jamaica.

Objective: To determine the prevalence of personality disorders in patients admitted to the psychiatric wards of the University Hospital of the West Indies (UHWI).

Method: Patients (n = 100) sequentially admitted to the psychiatric wards of the UHWI were assessed for personality disorder using the gold standard of a consultant assessment using the Diagnostic and Statistical Manual of Mental Disorders, 4th edition, text revision (DSM IV-TR) diagnostic criteria for personality disorder, the International Personality Disorder Examination Screening questionnaire (IPDE-S), and the Jamaica Personality Disorder Inventory (JPDI).

Results: The three assessment instruments identified a prevalence of personality disorder in the cohort of patients of 51% consultant DSM-IV-TR assessment, 57% JPDI and 86% IPDE-S.

Personality disorder in convicted Jamaican murderers.

Objective: To establish the aetiology and historical prevalence of personality disorder in violent homicidal men in Jamaica.

Methods: Examination and analysis of primary data from the psychosocial case study interviews of 36 convicted murderers from the Jamaican Government Barnett Commission of Enquiry in 1976. The disaggregated social and clinical data were analysed using a Chi-square statistical analysis.

Media representation of personality disorder in Jamaica - public scholarship as a catalyst of health promotion.

Objective: To ascertain whether the public scholarship of the epidemiology of personality disorder (PD) in Jamaica prompted a health promotion outcome.

Methods: A January 2011 to December 2012 trawl of news media articles linking 'PD' to published public scholarship articles on the epidemiology of PD recorded titles and contents of the reports that were culled to capture the emotional responses and psychological defence mechanisms expressed. These were analysed with concomitant social, psychological or behavioural activities occurring in Jamaica, using SPSS version 17 software.

Prevalence and correlates of personality disorder in the Jamaican population.

Objective: To identify the prevalence and correlates of personality disorder in a representative sample of the Jamaican population using the Jamaica Personality Disorder Inventory (JPDI).

Method: A four-stage stratified random sampling method was used to obtain a representative population sample consisting of 1506 Jamaicans, M:F = 727 (48.3%):779 (51.

The treatment of personality disorder in Jamaica with psychohistoriographic brief psychotherapy.

Objective: To assess the clinical outcome of patients with personality disorder, receiving treatment with psychohistoriographic brief psychotherapy (PBP).

Method: Patients seen in the author's private practice from 1974-2010 with a Diagnostic and Statistical Manual of Mental Disorders, fourth edition, text revision (DSM-IV-TR) personality disorder diagnosis were treated with PBP. Demographic, clinical responses and one-year clinical outcome measures were disaggregated and analysed, using SPSS, version 17.

Correlates of psychosexual issues in the Jamaican population.

Objective: To examine the relationship between the psychopathological correlates of psychosexual phenomena in post-colonial Jamaica.

Methods: A total of 1506 adult individuals were sampled from 2150 households using a stratified sampling method and assessed with the Jamaica Personality Disorder Inventory (JPDI). Responses to the seven questions on the psychological features of homosexual practices, sexual practices and dysfunction were tabulated and analysed using the Statistical Package for the Social Sciences (SPSS) version 17.

The psychological correlates of dependency in the Jamaican population.

Objective: To establish the prevalence of psychological dependency in the Jamaican society in order to examine the relationship between the psychological correlates of dependency and socio-political dependency in this post-colonial country.

Methods: A total of 1506 adult individuals were sampled from 2150 households using a stratified sampling method and assessed using the 17 questions of the Jamaica Personality Disorder Inventory (JPDI) on the phenomenology of dependency that are grouped into the psychological features of physiological dependency, financial dependency, and psychological dependency. The database of responses to the demographic and JPDI questionnaires was created and analysed using the Statistical Package for the Social Sciences (SPSS) version 17.

Correlates of conflict, power and authority management, aggression and impulse control in the Jamaican population.

Objective: The object of this study is to establish the correlates of the phenomenology of conflict and power management in the Jamaican population.

Methods: A total of 1506 adult individuals were sampled from 2150 households using a stratified sampling method and assessed using the 12 questions of the Jamaica Personality Disorder Inventory (JPDI) on the phenomenology of conflict and power management that are grouped into the psychological features of aggressive social behaviour, unlawful behaviour, socially unacceptable behaviour and financial transgressive behaviour. The database of responses to the demographic and JPDI questionnaires was created and analysed using the Statistical Package for the Social Sciences (SPSS) version 17.

Shakatani: the phenomenology of personality disorder in Jamaican patients.

Objective: To examine the distribution and clinically significant patterns of the phenomenology of a cohort of Jamaican patients with a Diagnostic and Statistical Manual of Mental Disorders (DSM) Axis II diagnosis of personality disorder and to clarify the conventional diagnostic deficiencies of DSM-based personality disorder categories.

Methods: In a case-control study from the naturalistic clinical setting of a private psychiatric practice in Kingston, Jamaica, between 1974 and 2007, the phenomenology of a cohort of 351 patients with an Axis II DSM diagnosis of personality disorder is qualitatively described and quantitatively compared with that of a control group of patients with an Axis I DSM clinical diagnosis, matched for age, gender and socio-economic class.

Results: There were 166 males (47.

The creation and validation of the Jamaica Personality Disorder Inventory.

Objective: To describe the creation and validation of the Jamaica Personality Disorder Inventory (JPDI) screening questionnaire.

Method: Using the phenomenological triad of power management, dependency and psychosexual issues, drafts of the JPDI were piloted on patients from psychiatric and medical wards. The JPDI consisted of 38 close-ended, yes/no questions.

A view of personality disorder from the colonial periphery.

Objective: To examine the history of personality disorder in the context of contemporary post-colonial Jamaican society.

Methods: The literature outlining the development and classification of personality disorder is reviewed. The social, psychiatric and epidemiological studies of personality disorder in Jamaica are presented.

Caribbean contributions to contemporary psychiatric psychopathology.

The intellectual exploration of phenomenological and psychiatric discovery that has flowered in the Caribbean in the period of political independence from British colonization is a reflection of the scholarship that has emerged from the academic nurturance by The University of the West Indies. Burgeoning migration of Caribbean people to England in the twentieth century has resulted in high reported rates of psychosis for this migrant population. Caribbean research into this condition has revealed that there exist hostile racial and environmental challenges in Britain that have had a profound pathological effect on the mental health of African Caribbean migrants.

Decolonization of psychiatric public policy in Jamaica.

Involuntary commitment and custodialization were the principal tenets of British colonial public policy provisions for the management of the violent, disturbed mentally ill in Jamaica and the West Indies. Over the fifty years following Jamaica's political independence from Britain, a community engagement mental health programme has developed through a decolonization process that has negated involuntary certification, incarceration and custodialization, has promoted family therapy and short stay treatment in conventional primary and secondary care health facilities, and has promoted reliance on traditional and cultural therapies that have been extremely successful in the treatment of mental illness and the reduction of stigma in Jamaica. Collaborations involving The University of the West Indies, the Jamaican Ministry of Health and the Pan American Health Organization have been seminal in the development of the decolonizing of public policy initiatives, negating the effects of involuntary certification that had been imposed on the population by slavery and colonization.

Issues of clinical and cultural competence in Caribbean migrants.

The level of out-migration from the Caribbean is very high, with migration of tertiary-level educated populations from Caribbean countries being the highest in the world. Many clinicians in receiving countries have had limited diagnostic and therapeutic experience with Caribbean migrants, resulting in diagnostic and therapeutic controversies. There is an urgent need for better understanding of these cultural differences.

Understanding patients in multicultural settings: a personal reflection on ethnicity and culture in clinical practice.

Objective: To identify and discourse on the complexities of ethnicity and culture, their role in the social and psychological functioning of patients and their potential impact on clinical assessment and treatment of these patients in diverse cultural contexts.

Design: Description of aspects of the cultural competence required by clinicians in mental health service provisions in therapeutic interactions involving the therapist and patient and also in the encounter between practitioners.

Results: The four-decade clinical experience of the author, an African Jamaican psychiatrist, encompasses clinical experience in the Caribbean, North America, Europe and New Zealand.

Redefining personality disorder: a Jamaican perspective.

Objective: To characterize and assess the factor structure of phenomenological features of DSM-IV personality disorder diagnosis in Jamaican patients and determine any similarities with those of traditional criteria, associations with disorder severity, and/or significant relationships between variables to inform the current debate on the relevance of established personality disorder diagnostics.

Methods: This was a case-control study. All the patients included were seen by one private psychiatric practice from 1974 to 2007.

Deinstitutionalization and attitudes toward mental illness in Jamaica: a qualitative study.

Objective: To consider whether or not deinstitutionalization and the integration of community mental health care with primary health care services have reduced stigma toward mental illness in Jamaica.

Methods: A qualitative study of 20 focus groups, with a total of 159 participants grouped by shared sociodemographic traits. Results were analyzed using ATLAS.