644 T. Pienkowski et al.
discrete differences between) them and counting the in- stances in which respondents explicitly connected two given themes. (5) Defining and naming themes (see Supplementary Table 2 for definitions of the key themes). One of the emergent themes related to symptoms of
‘thinking too much’. We evaluated the extent to which these symptoms appeared to describe emotional distur- bance that impaired day-to-day activities and social function- ing (Drapeau et al., 2012). The expected ways in which the positionality of the authors could have influenced the results and the steps taken to account for these are discussed in SupplementaryMaterial 7.
Results
We interviewed 21 men and 24 womenwith a range of demo- graphic and socioeconomic characteristics (Supplementary Material 3). We discussed a broad range of themes during the interviews, but only those most frequently mentioned and relevant to the research questions are presented here (but see Supplementary Material 8).
How do the residents of Nyabyeya Parish describe their experiences of distress?
Terms used to describe the experience of distress included kufikiri sana in Kiswahili and kuterageza muno in Runyoro, both of which translate to ‘thinking too much’ in English. For instance, respondent R05 (lower-income older female) said, ‘It brings me so many thoughts, I think too much.’ When asked about the experience of ‘thinking too much’, respondents mentioned a range of experiences or symptoms (Fig. 3). For instance, R29 (lower-income middle-aged male) stated, ‘You find yourself growing thin- ner and thinner. Like the way they say that too many thoughts cause pressure.’ Several reported that the experi- ence of ‘thinking too much’ disrupted daily activities. For example, R09 (middle-income middle-aged male) said, ‘You sleep from now [early evening at the time of the inter- view] up till 10 am, [but] you are supposed to wake up and get your hoe and start digging, so those are all about thoughts.’ Several respondents indicated that the frequency and
duration of ‘ thinking too much’ depended on the presence of specific stressors. For instance, when asked how to allevi- ate ‘thinking too much’,R38 (middle-income older male) said, ‘There is no way you can reduce those thoughts if you are still with those challenges. [Those thoughts only dis- appear when] those challenges are not there.’ However, sev- eral others indicated that the experience of ‘thinking too much’ was more chronic, such as R27 (lower-income middle-aged female), who said, ‘You cannot imagine the period that those thoughts can get finished from you.’
What are the perceived stressors associated with distress amongst residents?
Many respondents reported that poverty, bad health and in- adequate food were associated with ‘thinking too much’ (Fig. 4). For instance, when asked what the term ‘overthink- ing’ meant, R20 (middle-income older female) responded, ‘No energy for digging, no money, [which] brings famine; it makes you overthink. You start thinking, what will I eat?’ Although being poor was an umbrella term for some- one’s socio-economic condition, it was often associated with insufficient money to meet essential needs. These needs in- cluded basic housing, paying for healthcare and school fees and buying food. Therefore, in the following, we use the term ‘poverty’ to mean inadequate money. Many respondents used the terms ‘famine’ and ‘hunger’
to describe not having enough food. When asked how this affected them, several respondents mentioned reducing the number of meals eaten per day, eating less favoured food or reducing dietary diversity. For instance, when asked about the experience of hunger, R13 (middle-income younger male) stated, ‘You cannot eat expensive things, and if you have been eating like four cups of posho (maize flour) now, you end up reducing to two cups.’ Although a few re- spondents indicated that the current experience of hunger was a cause of ‘thinking too much’, many more said that the prospect of food supplies running out before the next harvest caused them distress.
Oryx, 2024, 58(5), 641–649 © The Author(s), 2024. Published by Cambridge University Press on behalf of Fauna & Flora International doi:10.1017/S0030605323001710
FIG. 3 The reported experiences or symptoms of ‘thinking too much’ amongst respondents in Nyabyeya Parish, Uganda. The width of the lines illustrates the relative number of interviewees that reported connections between nodes. The node size represents the number of interviewees mentioning the associated theme for that node.
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