Explanatory Model Interview Catalogue (EMIC): Framework for Comparative Study of Illness

Mitchell Weiss

doi:10.1177/136346159703400204

Abstract

The Explanatory Model Interview Catalogue (EMIC) refers to a collection of locally adapted explanatory model interviews rooted in a common framework. Efforts to develop the EMIC were motivated by research experience in cultural psychiatry and tropical medicine that demonstrated a need to integrate epidemiological and anthropological research methods more effectively. Various adaptations of the EMIC framework have produced semi-structured interviews based on an operational formulation of an illness explanatory model that systematically clarifies the experience of illness from the point of view of the people who are directly affected. Patterns of distress, perceived causes, preferences for help seeking and treatment, and general illness beliefs constitute a framework for the operational formulation of the illness explanatory model. Data sets generated from these EMIC interviews typically include quantitative variables and qualitative prose, which are cross-referenced for analysis to clarify key features and answer important questions about illness experience and its practical implications. This review discusses the development and structure of the EMIC, the adaptation of particular explanatory model interviews, the analysis of data obtained from these interviews, the scope of research they have addressed, and next steps in the development of the EMIC.

Highlights

Efforts to develop the Explanatory Model Interview Catalogue (EMIC) aimed to provide a method for cross-cultural research that incorporates advances in psychiatric epidemiology associated with semi-structured interviews and operational guidelines for recording and analyzing data (Robins, Wing, Wittchen, Helzer, Babor, Burke, Farmer, Jablenski, Pickens, Regier, Sartorius & Towle, 1988; Riskind, Beck, Berchick, Brown & Steer, 1987; Kraemer, Pruyn, Gibbons, Greenhouse, Grochocinski, Waternaux & Kupfer, 1987), as well as advances in medical anthropology and the socalled new cross-cultural psychiatry (Littlewood, 1991; Kleinman, 1988a; Kleinman, 1977)
It differs from standard instruments of psychiatric epidemiology in two respects: the EMIC is a catalogue of explanatory model interviews based on an adaptable, operational framework and the experience acquired from their use; it is not a single instrument for generic use irrespective of particular clinical and cultural contexts
As the distinctive nature and variety of studies associated with the EMIC makes clear, these explanatory model interviews are not ready-to-use research instruments like the Hamilton scales for depression and anxiety

Summary

Conclusion

As the distinctive nature and variety of studies associated with the EMIC makes clear, these explanatory model interviews are not ready-to-use research instruments like the Hamilton scales for depression and anxiety,. Insofar as the initial effort to develop the EMIC identified it as an interview catalogue, the project remains a work in progress Such a catalogue is still needed as a guide for developing comparable explanatory model interviews informed by a growing body of experience, which provides a source of illustrative questions, strategies for coding, details of data management, and techniques for analysis. Until such a comprehensive version of the EMIC is available, this review may serve in its place as an account of the development and uses of explanatory model interviews associated with the EMIC

Figures and Table

Findings

Summary judgment comparing multiple responses