1

Psychology 307: Cultural Psychology

Health

2

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?

Health

3

What is a psychological disorder?

● Consider the following scenario:

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.

4

● 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.

5

● In recent years, researchers have become increasingly interested in examining differences in the occurrence and prevalence 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.

6

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 worthlessness or guilt, and suicidal ideation.

7

Across cultures, medical practitioners have identified individuals who display this pattern of symptoms, suggesting that depression is a universal psychological disorder.

8

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).

9

Several theories have been proposed to account for cultural differences in the primary symptoms of depression:

(a) Cultural differences in the social stigma associated with a psychological disorder versus a 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.

10

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.

11

Multinational studies (Colombia, Czechoslovakia, Denmark, England, India, Nigeria, the Soviet

Union, Taiwan, U.S.; 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.

12

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).

13

3. Other disorders

There are several other psychological disorders identified by the DSM that are found across cultures:

Social anxiety disorder

Attention-Deficit/Hyperactivity Disorder (ADHD)

Personality disorders (e.g., antisocial personality disorder)

14

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.

15

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.

16

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.

17

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.

18

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.

19

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.

20

Brought on by starvation anxiety.

5. Other disorders

The DSM recognizes a host of other culture-bound syndromes: Ataque de nervios, Brain fag, Dhat, Frigophobia, Koro, Latah, Locura, Mal de ojo, Rootwork, Susto, Whakama, and Zar are among them.

21

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.

22

● Research has established the effectiveness of these approaches for treating North Americans of European descent.

● Moreover, the scant research that has examined the effectiveness of these approaches with other cultural groups suggests that they are effective.

23

● 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.

24

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:

25

(a) Total bed rest and isolation.

(b) The patient is permitted to do light work and begins to write a diary, but is forbidden from contact with others.

(c) The patient is permitted to engage in heavier work and begins to attend lectures on self-control and the evils of egocentricity.

(d) The patient gradually returns to full social life but continues to have contact with the therapist.

26

2. Naikan therapy

Developed in Japan.

Goals of therapy:

(a) The discovery of personal, authentic guilt for having been ungrateful and troublesome to others in the past

(b) The discovery of positive gratitude towards individuals who have extended themselves on behalf of the patient at some time in the past.

27

Procedure: The patient introspects from 5:30 a.m. to 9 p.m. for 7 days. The patient is instructed to look at his/her 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)

28

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?

Health