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Table 2 Causal Attributions, Explanatory models, Idioms of Distress and Corresponding Symptoms and Signs

From: Perinatal depression in Nigeria: perspectives of women, family caregivers and health care providers

Causes Mechanisms Idioms of distress and illness termsa Symptoms and signs
[lay theory]
1. Husband not emotionally caring 1. Thinking too much [excessive rumination] Group 1 (milder illness): Eforitulu, Sleeplessness, Deep thought, Stress, Sickness after birth, Emotional deficiency, Depressive disorder, Waku-gbari Symptoms: irrational talk and behavior, feeling down and sad, poor sleep, aimless wandering, low energy, poor appetite, weight loss, headaches
2. Problems with in-laws 2. Rise in blood pressure [local theory of stress] Group 2 (more severe illness): Aisan opolo, Abisinwin, Madness, Mental problem, Insanity Signs: irrational talk and behavior, looks dejected, sad, poor sleep, aimless wandering, low energy, poor appetite, weight loss, socially withdrawn, headaches, low self esteem, neglecting to care for baby
3. Spiritual attack 3. Envy by others   
4. Wanting a male child [sorcery-witchcraft]   
5. Shock-traumatic event 4. Not ordinary causation [supernatural causation]   
6. Not resting after delivery 5. Eating in dream [mystical means]   
7. Sleeplessness 6. Sleeplessness [naturalistic causation]   
8. Medical causes (infections, pregnancy complications, difficult labor) 7. Headaches [naturalistic causation]   
  8. Eyeballs white   
  [blood shortage-balance theory]   
  9. High temperature   
  [hot and cold-balance theory]   
  10. Taboo violation [supernatural punishment]   
  1. aThe grouping reflects presumed causation, severity, course