CULTURE AND PSYCHOPATHOLOGY PSYC 338. Culture and Psychopathology What’s normal and abnormal ?...

CULTURE AND PSYCHOPATHOLOGY

PSYC 338

Culture and Psychopathology• What’s normal and abnormal ?• Expression of Abnormal Behavior• Assessment and Diagnosis of

Abnormal Behavior• Explanations of Psychopathology• Treatment

Culture and Psychopathology• What’s normal and abnormal ?

Roots of inquiry into Culture and Psychopathology• Kraepelin (1904) found, on his

world tour promoting his system of diagnosis that some cultures may need further examination in diagnosis of their disorders (e.g. latah).

Culture permeates all aspects of Psychopathology

• Experience• Expression• Explanation• Assessment• Treatment

Explanations of Psychopathology• Biological• Psychological• Social• Ecological• Spiritual

Case Studies

A Pakistani patient complains of pain and weakness

“ I have pains in my head, I have a body ache” “ I have lost all of my strength”

What’s your diagnosis?

Expression of Abnormal Behavior

Symptoms of depression as an affective disorder

Affect- depressed mood Behavior- withdrawn Cognitive- guilt, worthlessness Somatic complaints

Is depression manifest the same way across cultures?

Feelings of Guilt

Guilt-based societies:“I have done something wrong, and even if it is never discovered and nobody else but me knows about it, I am distressed and disgusted with myself.”

Shame-based societies:“I have done something wrong in the eyes of other people. People who matter to me are disgusted with my behaviour, and therefore I am distressed because I cannot face them.

What’s normal? Mental illness in a Laotian village• Dangerous behavior• Disruptive and dysfunctional

activities• Communication problems• Delusions• Inappropriate affect• Somatic symptoms

Culture Specific Idioms of Disease• Nervios• Ataque de nervios• Rootwork• Susto

Culture Specific Idioms of Disease• Nervios

emotional distress, headaches, irritability, stomach disturbances, sleep disturbances, nervousness, easy tearfulness, inability to concentrate, tingling sensations, and dizziness

Culture Specific Idioms of Disease

Ataque de nerviosuncontrollable shouting, attacks of crying, trembling, heat in the chest rising to the head, and verbal or physical aggression

Culture Specific Idioms of Disease• Rootwork

illness as the result of hexing, witchcraft, voodoo, or the influence of an evil person

Culture Specific Idioms of Disease• Susto

illness attributed to a frightening event that causes the soul to leave the body, leading to symptoms of unhappiness and sickness

Culture Bound Syndromes

• Latah• Amok• Koro• Anorexia nervosa

Culture Bound Syndromes

• Latahhypersensitivity to sudden fright, often with echopraxia, echolalia, command obedience, and dissociative or trancelike behavior

Culture Bound Syndromes

• Amokdissociative episode characterized by a period of brooding followed by an outburst of violent, aggressive, or homicidal behavior directed at people and objects

Culture Bound Syndromes

• Korosudden and intense anxiety that the penis (or in the rare female cases, the vulva and nipples) will recede into the body and possibly cause death

Culture Bound Syndromes

• Anorexia nervosasevere restriction of food intake, associated with morbid fear of obesity

“Dissociative disorders”

“Dissociative disorders”

Kleinman writes: ‘trance and possession states are ubiquitous in non-western societies and were so in the West prior to the modern age ... Only the modern secular west seems to have blocked individuals’ access to these otherwise pan-human dimensions of self’ (1988, p.50).

Trance and possession

•Zar (East Africa)•Spell (Southern US)•Izizwe (Zulu, South Africa)•Speaking in toungues (Fundamentalist Christain US)•Kitsune possession (Japan)

Trance and possession•Kitsune possession (Japan)