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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.

4. discuss cultural similarities in rates of schizophrenia.

3. define the term alexithymia.

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6. generate examples of culture-bound disorders.

5. discuss cultural differences in the symptoms and prognosis of schizophrenia.

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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).

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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Brought on by environmental conditions (e.g., isolation, darkness) and dietary deficiencies.

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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Mental Health

1. What is a psychological disorder?

2. What psychological disorders are universally recognized?

3. What psychological disorders are culture-bound?