Transcript Culture and Psychopathology

CULTURE AND PSYCHOPATHOLOGY
PSYC 338
Culture and Psychopathology
• What’s normal and abnormal ?
• Expression of Abnormal Behavior
• Assessment and Diagnosis of Abnormal
Behavior
• Explanations of Psychopathology
• Treatment
Culture and Psychopathology
• What’s normal and abnormal ?
Roots of inquiry into Culture and
Psychopathology
• Kraepelin (1904) found, on his world
tour promoting his system of
diagnosis that some cultures may
need further examination in diagnosis
of their disorders (e.g. latah).
Culture permeates all aspects of
Psychopathology
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Experience
Expression
Explanation
Assessment
Treatment
Explanations of Psychopathology
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Biological
Psychological
Social
Ecological
Spiritual
Case Studies
A Pakistani patient complains of pain and
weakness
“ I have pains in my head, I have a body ache”
“ I have lost all of my strength”
What’s your diagnosis?
Expression of Abnormal Behavior
Symptoms of depression as an affective disorder
Affect- depressed mood
Behavior- withdrawn
Cognitive- guilt, worthlessness
Somatic complaints
Is depression manifest the same way across cultures?
Feelings of Guilt
Guilt-based societies:
“I have done something wrong, and even if it is never
discovered and nobody else but me knows about it, I am
distressed and disgusted with myself.”
Shame-based societies:
“I have done something wrong in the eyes of other people.
People who matter to me are disgusted with my behaviour,
and therefore I am distressed because I cannot face them.
What’s normal?
Mental illness in a Laotian village
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Dangerous behavior
Disruptive and dysfunctional activities
Communication problems
Delusions
Inappropriate affect
Somatic symptoms
Culture Specific Idioms of Disease
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Nervios
Ataque de nervios
Rootwork
Susto
Culture Specific Idioms of Disease
• Nervios
emotional distress, headaches, irritability,
stomach disturbances, sleep disturbances,
nervousness, easy tearfulness, inability to
concentrate, tingling sensations, and
dizziness
Culture Specific Idioms of Disease
Ataque de nervios
uncontrollable shouting, attacks of crying,
trembling, heat in the chest rising to the
head, and verbal or physical aggression
Culture Specific Idioms of Disease
• Rootwork
illness as the result of hexing, witchcraft,
voodoo, or the influence of an evil person
Culture Specific Idioms of Disease
• Susto
illness attributed to a frightening event
that causes the soul to leave the body,
leading to symptoms of unhappiness and
sickness
Culture Bound Syndromes
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Latah
Amok
Koro
Anorexia nervosa
Culture Bound Syndromes
• Latah
hypersensitivity to sudden fright, often with
echopraxia, echolalia, command
obedience, and dissociative or trancelike
behavior
Culture Bound Syndromes
• Amok
dissociative episode characterized by a
period of brooding followed by an outburst
of violent, aggressive, or homicidal
behavior directed at people and objects
Culture Bound Syndromes
• Koro
sudden and intense anxiety that the penis
(or in the rare female cases, the vulva and
nipples) will recede into the body and
possibly cause death
Culture Bound Syndromes
• Anorexia nervosa
severe restriction of food intake,
associated with morbid fear of obesity
“Dissociative disorders”
“Dissociative disorders”
Kleinman writes: ‘trance and possession
states are ubiquitous in non-western
societies and were so in the West prior to the
modern age ... Only the modern secular west
seems to have blocked individuals’ access to
these otherwise pan-human dimensions of
self’ (1988, p.50).
Trance and possession
•Zar (East Africa)
•Spell (Southern US)
•Izizwe (Zulu, South Africa)
•Speaking in toungues (Fundamentalist
Christain US)
•Kitsune possession (Japan)
Trance and possession
•Kitsune possession (Japan)