Culturele psychiatrie

7 Vervagende grenzen

MARIO BRAAKMAN, PSYCHIATER/CULTUREEL ANTROPOLOOG

EDE 21 JUNI 2017

Cultuur iscontext

1. Culturele

competenties

2. Cross-cultureelempirisch onderzoek

(epidemiologie,

etiologie,

symptoomexpressie)

3. Psychiatrie als cultuur

Literatuur over trauma en psychose

3 citeernetwerken

(Scholarly networks)

- Childhood trauma >> psychose

- PP-PTSD

- PTSD-SP

PTSD-SP “Schizophrenia”

1.

Phenomenological differences between PTSD-SP and schizophrenia?

(symptom profiles, comorbidity, age of onset, sociodemographic variables, type of trauma)

?

Positieve symptomen PANSS

Negatieve symptomen PANSS

General psychopathology PANSS

Braakman 2013

These three variables predicted 90.2% of the

patients correctly as belonging to the

PTSD-SP or schizophrenia group

(Nagelkerke’s adjusted R Square = 0.73, sensitivity= 91%, specificity = 88%,

positive predictive value = 94%, negative predictive value

= 83%).

Het culturele perspectief

Allianz-Chef Henning Schulte-Noelle

Franz Burda: Gründer

des Burda-Verlags

(heute Hubert Burda

Media).

Ein Schmiss ist eine

in einer

studentischen

Mensur

davongetragene

Schnittverletzung

sowie die daraus

entstandene

Narbe.

Schmiss

Pathogenetic effects

Culture is direct causative: Eg. koro or dhat

Pathoselective effects

Select cultural reaction patters resulting in psychopathology Eg. Family-suicide in Japan

Pathoplastic effects

Culture contributes to the modelling of the manifestations of psychopathology: Eg. J.Chr. / CIA/KGB

Pathoelaborating effects

Universal behavior exaggerated to the extrem through cultural reinforcements. Eg. Latah/ hara-kiri

Pathofacilitative effects

Facilitating effects of culture: Eg. Anorexia nervosa

Pathoreactive effects

Influence people’s beliefs and understanding of the disorder: Eg. susto

Culture >>> psychopathology

V24.- Most

people can be

trusted

Paranoidie

Cultuur-syntone achterdocht

Vluchteling zijn (gezond overlevingsmechanisme)

Traumatische ervaringen

PTSS

Psychose

Culturele grenzen

door de tijd heen

1981-2015

psychiater patiënt

Transculturele competenties

psychiater patiënt

Transculturele competenties

Diagnostiek

Therapie

Diagnostiek

Therapie

1. Culturele formulering

2. Psychotherapie

3. Farmacotherapie

Hulpmiddelen:

4. vragenlijsten/testen

5. tolken

Acculturatiemodel van Berry

assimilatie integratie

marginalisatie segregatie

Gastcultuur overnemen

Gastcultuur verwerpen

Cultuur van herkomst

verwerpen

Cultuur van herkomst

behouden

Michael W. Smith, 2002

Bains et al 2012

Chiao, 2010

(a) Colour map of frequency distribution of IND-COL

from Hofstede (2001). (b) Colour map of frequency

distribution of S alleles of 5-HTTLPR.

Geographical coincidence between serotonin transporter gene diversity and

cultural traits of individualism – collectivism across countries.

Chiao, 2010

Every man is in certain respects:

Like all other men

Like some other men

Like no other man

Lim, 2002

Dank voor uw aandacht!