Indigenous Categories of Distress and Dysfunction in South African Xhosa Children and Adolescents as Described by Indigenous Healers

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Abstract
There is a paucity of information on indigenous idioms and categories of distress in children and adolescents in South Af rica. Indigenous healers were asked to provide descriptions of indigenous idioms and categories of distress in children and adolescents in a predominantly Xhosa speaking community. The healers identified five indigenous categories of distress, namely ukuphaphazela, isimnyama esikolweni ukuthwasa, ukuphambana, amafufunyana. These are compared with available descriptions in the literature and differences in presentation and understanding are discussed. The study confirmed that indig enous categories of distress not only affect adults, but also children and adolescents, and that 'brain fag' also occurs in South Africa. The results of this study indicate that indigenous categories of distress such as amafufunyana, ukuthwasa and ukuphambana require an emic approach and may be best un derstood at the individual level. Etic approaches, such as inclusion in psychiatric epidemiological studies are not suit able for these categories because symptoms are not prioritized. Categories such as isimnyama esikolweni and ukuphaphazela, which are associated with more discrete symptoms, could fea sibly be included in epidemiological investigations.

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