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Dina Kulenovic, Charles T. LoPresto, Ph.D.

Impact of Acculturation on Mental Health Stigma in Bosnian Immigrants and Refugees

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The purpose of this study is to evaluate the impact of acculturation on preexisting views of mental illness among Bosnians immigrants and refugees. Approximately 90,000 Bosnians relocated to the United States between 1990 and 2000, most of which are presumed to have relocated as a result of the 1992-1995 Bosnian civil war (U.S. Census, 2000). The research that exists on this population has focused primarily on the psychological impact of the war and subsequent life satisfaction in the United States. However, research beyond this scope is limited, making it difficult for scholars and mental health professionals to conceptualize Bosnian mental health ideology, without the influence of trauma as a potential confound. The findings of this study are expected to contribute to the literature about mental illness as it pertains to this population in general, but more importantly, to inform treatment for service providers who may work with individuals who belong to this group.

Based on the literature that suggests that U.S. populations possess less negative attitudes toward mental illness and help-seeking behavior than the native Bosnian population, and that Bosnian culture is characterized by resiliency and high adaptability, the hypotheses for the proposed study are as follows: Bosnian immigrants and refugees will possess a more accurate general knowledge about mental illness, will have more positive attitudes toward individuals with mental illness, and will be more accepting and tolerant of individuals with mental illness than Bosnian individuals who currently reside in Bosnia and Herzegovina. It is expected that there will be a positive association between level of acculturation and attitudes toward individuals with mental illness, the level of acceptance and tolerance for individuals with mental illness level of knowledge about mental illness among the Bosnian immigrant and refugee population.

The methodology of the proposed study will replicate that of a recently conducted study by the Institute for Public Health of the Federation of Bosnia and Herzegovina. These researchers were interested in determining the prevalence of mental health stigma among adults, health care workers, and the media in Bosnia and Herzegovina in order to develop effective campaigns aimed at reducing stigma and social exclusion of persons with mental illness. However, because the focus of the present study is to evaluate mental health stigma within the Bosnian immigrant and refugee population in the U.S., only the materials used for data collection of the general adult sample in the original study will be used in data collection for the present sample. Mental health stigma will be assessed by measuring social distancing behavior – the degree to which individuals are accepting and tolerant of individuals with mental illness, attitudes toward and general knowledge about mental illness. The measures used will be a modified version of the Bogardus Social Distance scale, the Community Attitudes Toward the Mentally Ill scale, and an original scale developed by the researchers to evaluate knowledge about mental illness. The proposed study will also include an additional measure to evaluate how acculturation may be related to the findings within the present sample (the Vancouver Index of Acculturation). The sample will be obtained online through e-mail and a “group” on Facebook developed specifically for this study, where the link to the survey will be accessible. 


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