Reflechi tw  p--thinking too much: description of a cultural syndrome in XXXX .

@entity1 @entity1032 @entity6220 @entity146 @entity914 @entity161 @entity716
A rich Haitian ethnopsychology has been described, detailing concepts of personhood, explanatory models of illness, and links between mind and body. However, little research has engaged explicitly with @entity1032 , and that which does focuses on the Krey  l term fou (madness), a term that psychiatrists associate with @entity161 and @entity914 . More work is needed to characterize potential forms of mild-to-moderate @entity1032 . Idioms of distress provide a promising avenue for exploring common @entity146 . Working in @entity6220 , we aimed to identify idioms of distress that represent cultural syndromes. We used ethnographic and epidemiologic methods to explore the idiom of distress reflechi tw  p (thinking too much). This syndrome is characterized by troubled rumination at the intersection of sadness, severe @entity146 , suicide, and social and structural hardship. @entity1 with "thinking too much" have greater scores on the Beck Depression Inventory and Beck Anxiety Inventory. "Thinking too much" is associated with 8 times greater odds of suicidal ideation. Untreated "thinking too much" is sometimes perceived to lead to @entity716 . Recognizing and understanding "thinking too much" may allow early clinical recognition and interventions to reduce long-term psychosocial suffering in @entity6220 .
