Transcript Jkjk - UBC Psychology`s Research Labs

Psychology 307:
Cultural Psychology
Lecture 20
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Mental Health
1. What is a psychological disorder?
2. What psychological disorders are universally recognized?
3. What psychological disorders are culture-bound?
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By the end of today’s class, you should be able to:
1. discuss cultural differences in rates of depression.
2. explain cultural differences in the symptoms of
depression.
3. define the term alexithymia.
4. discuss cultural similarities in rates of schizophrenia.
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5. discuss cultural differences in the symptoms and
prognosis of schizophrenia.
6. generate examples of culture-bound disorders.
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What is a psychological disorder?
A woman is in the midst of a group of people but seems
totally unaware of her surroundings. She is talking loudly
to no one in particular, is often using words that people
around her find unintelligible, and is occasionally barking.
When later questioned about her behaviour, she reports
that she was talking with a man who had recently died
and had briefly been possessed by the spirit of a dog.
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● Psychological disorders are typically described as
states that:
(a) are statistically rare.
(b) cause subjective distress or impaired social
functioning.
● Cognitive or behavioural patterns that are described
as psychological disorders in one culture may not be
described as psychological disorders in other cultures.
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● In recent years, researchers have become increasingly
interested in examining differences in the occurrence
of psychological disorders across cultures.
● Their research has demonstrated that there are
psychological disorders that are universally recognized
and psychological disorders that are specific to distinct
cultural groups.
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What psychological disorders are universally
recognized?
1. Depression
 According to the DSM, depression is characterized by
a depressed mood, an inability to experience pleasure,
fatigue, changes in appetite or sleep patterns, poor
concentration, a sense of guilt or worthlessness, and
suicidal ideation.
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 Across cultures, medical practitioners have identified
individuals who display this pattern of symptoms,
suggesting that depression is a universal psychological
disorder.
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 Nevertheless, the prevalence of depression and the
primary symptoms of depression vary across cultures.
With respect to the primary symptoms of depression,
psychological symptoms are most frequently reported
in some countries (e.g., Canada, the U.S.), whereas
somatic symptoms are most frequently reported in
other countries (e.g., China, Mexico).
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 Neurasthenia is a relatively common diagnosis among
Chinese psychiatric patients, not found in the DSM.
Neurasthenia is characterized by somatic symptoms:
poor appetite, headaches, insomnia, inability to
concentrate.
Kleinman (1982) interviewed Chinese neurasthenia
patients and concluded that a majority (87%) could be
diagnosed as having depression, although only 9% of
them reported depressed mood as a chief complaint.
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 Several theories have been proposed to account for
cultural differences in the primary symptoms of
depression:
(a) Cultural differences in the stigma associated with a
psychological versus physiological disorder.
(b) Cultural differences in the tendency to attend to
psychological versus somatic symptoms.
(c) Cultural differences in the tendency to view the mind
and body as distinct entities.
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2. Schizophrenia
 According to the DSM, schizophrenia is characterized
by auditory and visual hallucinations, delusions,
disorganized speech, flat affect, and disorganized or
catatonic behaviour.
 Across cultures, medical practitioners have identified
individuals who display this pattern of symptoms,
suggesting that schizophrenia is a universal
psychological disorder.
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 Multinational studies (Colombia, Czechoslovakia,
Denmark, England, India, Nigeria, the Soviet Union,
Taiwan, US; WHO, 1973, 1919, 1981) indicate that the
prevalence of schizophrenia is similar across countries
and has remained relatively constant across time.
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 Nevertheless, the primary symptoms of schizophrenia
vary across cultures.
Paranoid schizophrenia is reported relatively frequently
in some countries (e.g., England, the U.S.), whereas
catatonic schizophrenia is reported relatively frequently
in other countries (e.g., India, Nigeria).
 The prognosis for schizophrenia is better for individuals
living in developing countries than individuals living in
developed countries.
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3. Other disorders
 There are several other psychological disorders
identified in the DSM that are found across cultures:
Social anxiety disorder
Attention-Deficit/Hyperactivity Disorder (ADHD)
Personality disorders (e.g., antisocial personality
disorder)
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What psychological disorders are culture-bound?
1. Amok
 The most widely observed culture-bound syndrome,
identified in several Southeast Asian countries (e.g.,
Malaysia, Indonesia, Thailand).
 More common among males than females.
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 Characterized by wild, aggressive behaviour of limited
duration in which there are attempts to kill or injure
others. Brooding and withdrawal proceed the outburst.
Exhaustion and amnesia follow the outburst.
 Precipitated by a slight or insult; brought on by
stress, sleep deprivation, and alcohol consumption.
 Hypothesized to emerge in societies that encourage
people to be passive and nonconfrontational; pent up
frustrations erupt as rage.
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2. Pibloktoq (Artic hysteria)
 Identified among Arctic and sub-Arctic Inuit
communities, such as the Greenland Eskimos.
 More common among females than males.
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 Characterized by extreme excitement, physical
violence, verbal abuse, and convulsions. Individuals
flee from protective shelters, tear off their clothing,
and expose themselves to the extreme temperatures.
Individuals may imitate the cry of an animal or bird
during the attack.
 Brought on by environmental conditions (e.g.,
isolation, darkness) and dietary deficiencies.
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Mental Health
1. What is a psychological disorder?
2. What psychological disorders are universally recognized?
3. What psychological disorders are culture-bound?
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