Discuss ethical and cultural consideration in diagnosis (culture variation, stigmatization) -

Abnormal psychology is a very broad topic in psychology, therefore the topic itself is split into 3 subsections, Anxiety disorders which is the form of irrational fear, Affective disorders which are the dysfunctional moods and eating disorders which are patterns of eating patterns which lead to excessive of insufficient amount of food

We are currently aware that there are some mental disorders, which are culturally universal such as schizophrenia, depression and manic depression.

(Culture causes misdiagnosis) Stevens (1987) had stated that the large amounts of differences in schizophrenia was due to the reason that misdiagnosis was occurring in developing countries, therefore the term differential diagnosis was coined by (Cochrane and Shashidharen(1995)) to explain the existence of cultural biasness in the diagnosis of mental disorders

Culture Bound Syndrome

A culture bound syndrome does not easily fit into the categories and classification of supposedly universal disorders, this form of a disorder happens exclusively to a certain cultural population or geographic area

Koro – this is a disorder in which when at times of high anxiety the penis or nipples will recede into the body and could possibly cause death

Amok - this is when somebody breaks out into a sudden wild behaviour, similar to that of ‘berserker’

o Knecht (1999) reported that this syndrome has been well known for many centuries in malay

o Wesermeyer (1973) analyzed existing data of 18 men in Laos who had been diagnosed with amok and found that certain case studies in Britain could also be potentially classified as amok, showing that this may not only be culturally bound

Therefore it is important to understand potential culture bound syndromes when it comes to diagnosis, a few potential ways of reducing culture bias is to..

o Take into account language differences, for therapists to become more culturally educated and to have patients identify themselves with different cultural groups

Supression Facilitation Model –

Weisz et al (1987) according to this model, forms of behaviour that are discouraged within a culture will be suppressed and therefore are observed more rarely, and vice versa, those that are more rewarded will be observed more often

o Weisz et al applied the model to Thailand and the USA, studying 400 children, and found that more of the thai children showed a more controlled behaviour patterns

Misdiagnosis

Stevens (1987) earlier stated that the main difference the different diagnosis of schizophrenia was because of misdiagnosis in developing countries, when 36% of Nigerian and 27% of indian patients recovered in under a month from schizo suggested they did not really have the disorder in the first place

Gender variations

Gender variations is an important consideration when it comes to diagnosis, for example those diagnosed with eating disorders are mainly women (90%) however this may cause therapists to be reluctant in diagnosing a man with eating disorders.

Robins et al (1984) performed a meta analysis of gender variances in 3 american cities and found that men had a higher alcohole abuse rate, more anti social behaviour however women are more likely to get major depression and specific phobias

Ford and Widiger (research evidence) o Presented therapists of written case studies and were then asked

to be identified as Male or Femaleo Anti social behaviour was correct 40% of the time when patient

was Male, but 20 when patient was female This showed a strong gender bias and that therapists had

resorted to simple gender stereotyping Bias in the definition of abnormality

o Broverman et al (1981) suggested that if the definition of abnormality was defined based on the gender stereotypes of men, then the symptoms shown in a woman may be unfairly diagnosed

Social Class Bias

Bruce, Takeuchi and Leaf (1981) found evidence that people above or below a socio economic line may have prejudice against them, those that had no mental illnesses at first assessment were assessed again 6 months later and it was found that those blow the line were 2x more likely to be diagnosed with a mental disorder, it is further looked at in schizophrenia.