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Lecture Notes 8 - Culture and Psychological Disorders
Cross-Cultural Psychology (21:830:322)
Rutgers University
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Culture and Psychological Disorders psychology Deviation from the the is not the same in all different locations around the world Extremes: disorders are primarily genetic versus strict cultural relativism E Fuller Torrey breaking down psychology into two categories: (the only true) Mental illness (psychosis or schizophrenia because they are brain diseases) General problems of living Then there is neurosis (some say this should be replaced bc the source of the problem is not necessarily in the neurons but their interactions with other people) more neutral term is not that helpful but it is the most innocuous and least controversial term (life has fallen out of order to some degree) Thomas Szasz Concept of a disorder is something certain people are trying to control that is out of the norm (trying to persecute people that are not like them) Are there symptoms people have of a certain disorder we have in this country? Are there instruments that are equivalent in other cultures? Cultural relativism concept Determining what is clinically significant Statistical deviance Somewhere around of Americans are eligible for at least 1 DSM disorder when people are manifesting these symptoms of the DSM, they are statistically deviant (deviating from the norm) There are people who do statistically deviant things all the time and you would not necessarily rush to say they are disordered Cultural deviance Violating social norms or stepping outside what we as a social norm consider to be behavior Not just that different behavior, but it makes others in the culture look at someone and wonder going on Emotional pain and personal distress Maladaptive As far as functioning Maladaptive against will This is where it becomes clinically significant Your will is subject to impulsivity or compulsivity and it is decided that you need some kind of help The disease model versus some other kind of model that does not rest strictly on genetics and brain chemistry Where to put the blame (morally, genetically, etc.) Typically placed (in U.) in the brain of the individual Cross cultural comparisons of diagnostic categories Main issues: reliability and validity of diagnoses U. uses DSM currently at DSM V, revised and edited to include or remove certain disorders in the manual Outside the U., DSM is not ICD 10 is used commonly around the world Specific cultural manuals within cultures, like CCMD (Chinese classification tool) Local manuals necessarily include certain diagnoses from the DSM (such as certain forms of addiction) if the ratings of the diagnosis are low, or if they consider it a disorder, etc. There will be disorders that are included in cultural diagnostic tools that are not in the U. DSM because people of the U. have this syndrome DSM once had disorders that are common in other places but not in the U. in the back of the manual Now use cultural concepts of distress coverage cultural aspect of psychopathology can be assessed in these ways: Cultural syndromes Cultural idioms of distress (ways people talk about their distress, even if we share them in common, they talk about it differently) Cultural explanations of where the distress came from (differentiating between causative factors and symptomatic factors) Review of over 300 medical records of ethnic minority or immigrant about half judged that had psychotic disorders, when looked at through a cultural lense, were reduced to disorders ICD 10 and DSM 5 considered to be attempts are atheoretical manuals Being theoretically neutral makes it sound judicious Coming from biomedical model People of all different theoretical perspectives DSM lingers at levels of symptoms and does not delve deeper into the this is still controversial, but less so than if you add etiology or epidemiology E Fuller Torrey disease mongering everyone wants a diagnosis so there is insurance reimbursement, etc. Starting to lump things together in spectrum disorders and subtypes is place on the autism spectrum) Diagnostic rates differ depending on which manual is being used Diagnoses doubled when using ICD in some countries OCD, for PTSD low level of cross over accounts for that doubling Cross cultural comparisons have found that you can find depressed people in most other as far as universal symptoms, typically psychosomatic (not eating, sleeping, concentrating, lack of energy, etc.) There are cultural presentations of the disorder that are more culture bound (in China, heart panic, heart dread, heart pain considered diseases of social insomnia is considered to be a causative factor rather than a symptom) Some culture bound illnesses: Amok, Zar, Baksbat, Susto, Latah, Koro Ethnic anomalies African Americans higher prevalence of schizophrenia and mood disorders Puerto Ricans have higher rates of mental illness than many other Latin cultures (American born have higher rates than those in Puerto Asian Americans have found lowest 12 month prevalence for major depression, anxiety disorder, panic disorder, Chinese women more likely to report depression than Vietnamese Filipino men more likely to report substance abuse than Chinese foreign born people less likely to have anxiety, depression, substance abuse than U. refugees higher rates of PTSD, depression, anxiety, even after 2 years of being in immigrants less likely to engage in deviant behavior Vocabulary Psychopathology: psychological disorders that encompass disorders that encompass behavioral, cognitive, and emotional aspects of functioning Cultural relativism: a viewpoint that suggests that psychological disorders can only be understood in the cultural framework within which they occur Cultural concepts of distress: the shared ways in which cultural groups or communities experience, express, and interpret distress Overpathologizing: misinterpreting culturally sanctioned behavior as expressions of pathological symptoms Underpathologizing: attributing pathological symptoms to normative cultural differences Somatization: psychological distress expressed as bodily symptoms
Lecture Notes 8 - Culture and Psychological Disorders
Course: Cross-Cultural Psychology (21:830:322)
University: Rutgers University
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