cross cultural psychiatry
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Cross-culturalpsychiatry
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What is culture?
• Culture refers to the meanings, values and behavioural norms that are learned and transmitted in the dominant society and within its social groups. Culture powerfully influences cognition, feelings, and self concept as well as the diagnostic process and treatment decisions
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What is Cross-cultural psychiatry?
• The cultural context of mental disorders• Studies the prevalence and form of
disorders in different cultures or countries
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What is Cross-cultural psychiatry?
• Early colonist psychiatrists and anthropologists assumed the universal applicability of Western psychiatric diagnostic categories
• A seminal paper by Arthur Kleinman in 1977 followed by a renewed dialogue between anthropology and psychiatry started a new cross-cultural approach to many psychiatric conditions
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CULTURE CAN CONTRIBUTE TO PSYCHOPATHOLOGY IN SIX DIFFERENT WAYS
• PATHOGENIC EFFECTS• PATHOSELECTIVE EFFECTS• PATHOPLASTIC EFFECT• PATHOELABORATIVE EFFECTS• PATHOFACILITATIVE EFFECTS• PATHOREACTIVE EFFECTS
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PATHOGENIC EFFECTS
• Pathogenic effects refer to situations in which culture is a direct causative factor in forming or ‘generating’ psychopathology
• Cultural ideas and beliefs contribute to stress, which in turn produces psychopathology
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PATHOGENIC EFFECTS EXAMPLES
• DHAT SYNDROMEA condition found in India where
patients show anxiety and hypochondriacal concerns associated with the discharge of semen
This is based on an old Hindu belief that it takes forty drops of blood to create a drop of bone marrow and forty drops of bone marrow to create a drop of sperm
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PATHOSELECTIVE EFFECTS
• Culture-specific coping patterns to deal with stress
• Examples:FAMILY SUICIDE: In Japan, cultural influences
may lead a family encountering serious stress to commit suicide together
AMOK ATTACK: In Malaysia, a man humiliated in public may feel a need to take a weapon and kill people indiscriminately to show his manhood
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PATHOPLASTIC EFFECT
• The ways in which culture changes the manifestations of the psychopathology
• Example:Religious delusions and delusional guilt are
primarily found in Christian societies than Islamic, Hindus or Buddhist
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ATHOELABORATING EFFECTS
• Certain behavior reactions may become exaggerated to the extreme in some cultures through cultural reinforcement
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ATHOELABORATING EFFECTS EXAMPLES
• In western countries and urban areas of developing countries there is increasing concerned with body weight in relation to health (a common reason for eating disorders)
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PATHOFACILITATIVE EFFECTS
• Culture may promote the frequency of occurrence
• A liberal attitude towards weapons control may result in more weapon-related violence or homicidal behaviour
• Cultural permission to consume alcohol freely may increase the prevalence of drinking problems
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PATHOREACTIVE EFFECTS
• Culture influences how people perceive pathologies and label disorders, and how they react to them emotionally, and then guide them in expressing their suffering
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PATHOREACTIVE EFFECTS EXAMPLE• Faith healing practices in cases of major
psychiatric disorders like schizophrenia, bipolar disorders or in OCDS . People attribute illness as results of “Black magic”.
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Culture-bound syndrome
a combination of psychiatric and somaticsymptoms that are considered to be a
recognizable disease only within a specific society or culture
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