Transcript 2 - UBC Psychology`s Research Labs

Psychology 307:
Cultural Psychology
Lecture 23
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Exam: April 21, 3:30-6:00 PM, Hebb Theatre
● For those students who did not write a paper, the exam
is worth one-third of your final grade; for those students
who did write a paper, the exam is worth one-quarter of
your final grade.
● The exam will be scored out of 50 points:
20-25 multiple choice questions (1 point each)
Short answer questions (ranging in value from 2 to 8
points, totaling 25-30 points)
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● In addition to questions related to lecture content, the
exam will include questions related to chapters 7, 9, 10,
and 12.
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● Bring a pencil, eraser, pen, and your student ID to the
exam.
● All electronic devices must be put away before the start
of the exam.
● Bags and backpacks should be left at the front of the
room. Please do not bring valuables to the exam.
● Hats (e.g., baseball caps) should not be worn during
the exam.
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Office Hours
I will hold my regular Friday office hours through to April 21st.
In the week prior to the final exam, I will hold additional
office hours:
Friday, April 15: 2:00-4:30
Tuesday, April 19: 1:00-3:00
Wednesday, April 20: 11:30-1:30
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Reminder
Please note that course evaluations are available online.
If you have not received an e-mail directing you to the
evaluations for this course, you may provide your
evaluation at: https://eval.olt.ubc.ca/arts.
Course evaluations will be available until April 10th.
Your feedback is extremely valuable—both to the
Psychology Department and to me.
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Health
1. What is a psychological disorder?
2. What psychological disorders are universally recognized?
3. What psychological disorders are culture-bound?
4. Are Western psychotherapeutic approaches effective for
the treatment of psychological disorders among
individuals living in non-Western cultures?
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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. discuss cultural similarities in rates of schizophrenia.
4. discuss cultural differences in the symptoms and
prognosis of schizophrenia.
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5. generate examples of culture-bound disorders.
6. describe “indiginous” forms of psychotherapy.
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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.
 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.
 Across countries, males are more likely to develop
schizophrenia than females.
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 Nevertheless, the primary symptoms of schizophrenia
vary across cultures.
Paranoid hallucinations and delusions (indicative of
paranoid schizophrenia) are most frequently reported in
some countries (e.g., England, the U.S.), whereas
catatonic behaviour (indicative of catatonic
schizophrenia) is most frequently reported in other
countries (e.g., India, Nigeria).
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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.
 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.
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 Brought on by environmental conditions (e.g.,
isolation, darkness) and dietary deficiencies.
3. Shinbyeong (Spirit sickness)
 Identified among Koreans.
 More common among females than males.
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 Characterized by a loss of appetite, weakness,
insomnia, dizziness, fear, and gastrointestinal problems.
The symptoms progress to include mental disturbances:
Dreams of communication with God, hallucinations,
dissociation, possession by ancestral spirits.
 Brought on by a spiritual “calling” to become a shaman.
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4. Witiko (Windigo psychosis)
 Identified among the Algonquian Indians.
 More common among males than females.
 Characterized by an insatiable desire to eat human
flesh even when other food sources are available.
Individuals are thought to be possessed by the “witiko
spirit.” If the condition cannot be cured, sufferers often
request that they be executed in order to avoid
harming others.
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 Brought on by starvation anxiety.
 A highly debated disorder (is it a racist fabrication?).
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5. Other disorders
 The DSM recognizes a host of other culture-bound
syndromes: Ataque de nervios, Brain fag, Dhat,
Frigophobia, Koro, Latah, Locura, Mal deojo, Rootwork,
Susto, Whakama, and Zar are among them.
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Are Western psychotherapeutic approaches effective
for the treatment of psychological disorders among
individuals living in non-Western cultures?
● Two evidence-based psychotherapeutic approaches
are frequently used in the treatment of psychological
disorders in Western cultures:
Cognitive-behavioural therapy: Modification of
debilitating thoughts and behaviours.
Interpersonal therapy: Interpersonal skills training.
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● Research has established the effectiveness of these
approaches for treating North Americans of European
descent.
● Moreover, the scant research (Miranda, 2005) that has
examined the effectiveness of these approaches with
other cultural groups suggests that they are effective.
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● Nevertheless, there has been an increased interest
among researchers in indigenous therapeutic
approaches.
● Several indigenous therapeutic approaches have
been identified. These approaches are
comparable to CBT and IPT in their effectiveness.
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1. Morita therapy
 Developed in Japan.
 Goal of therapy: To have patients accept reality rather
than attempt to bring reality in line with personal needs
and desires.
 Procedure involves 4 stages:
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(a) total bed rest and isolation.
(b) light work, maintenance of a diary, continued isolation
with the exception of therapist visits.
(c) heavier work, continued maintenance of a diary,
participation in lectures on self-control and the evils
of egocentricity.
(d) return to full social life, continued out-patient contact
with the therapist in group sessions.
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2. Naikan therapy
 Developed in Japan.
 Goals of therapy:
(a) The discovery of authentic guilt for having been
ungrateful and troublesome to others in the past.
(b) The discovery of gratitude towards individuals who
have extended themselves to the patient in the past.
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 Procedure: The patient introspects from 5:30 a.m.
to 9 p.m. for 7 days. The patient is instructed to look
at her/his relationships from 3 perspectives: Care
received, repayment, and trouble caused.
 Interviews are conducted every 90 minutes. The
interviews are conducted in “a boldly moralistic
manner, placing the burden of blame on the client
rather than on others” (Murase, 1982, p. 318).
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3. Chinese Taoist cognitive therapy
 Developed in China.
 Goal of therapy: To regulate patients’ negative affect
and correct maladaptive behaviour through the
reinforcement of Taoist principles.
Taoism “focuses on conforming to natural laws,
letting go of excessive control, and the flexible
development of personality” (Zhang et al., 2002).
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 Procedure involves 5 stages:
(a) identify stressors that contribute to the patient’s illness.
(b) examine the patient’s cognitive evaluations of the
stressors.
(c) analyze the patient’s primary coping styles.
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(d) have the patient read Taoist writings and reflect upon
the writings in a diary.
(e) assess the effectiveness of the treatment via patient
self-reports and clinical assessments.
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