PSYCHOPATHOLOGY

2 contrasting viewpoints

    Universalism (etic) = difference in presumably worldwide dimensions of psychopathology

    Relativism (emic) = scope of cultural variation and infusion of culture into psychopathology

Diagnosis

    US-UK Diagnostic Project and identified sources for diagnostic differences

    Diagnostic errors reflect 2 sources of cultural malpractice

        Deviance = Disturbance
        Cultural distance = Stereotyping

    Differential diagnosis is a complex process situated in a sociocultural context

        Cultural variability in symptom expression despite comparability of core symptoms and incidence rates; variation may decrease with severity

    Problems with etic diagnostic measures and categories led to the emergence of transcultural psychiatry

Depression

    Occurs across cultures, but no universal features

        WHO 1983 study of symptomology
        Lack of parental warmth

    Differences in language, familiarity, meaning, and historical context

    Guilt as a source of cultural variation

    Emic conceptions (e.g., 5 Hopi Indian illness categories)

Somatization

    Overlap with depression and other disorders

        Cultural variation in experience and communication (e.g., shenjing shuaiuro)

    Implications of the Western cultural tendency to dichotomize soma and psyche

Schizophrenia

    Occurs across cultures with similar incidence rates

    Prognosis is variable, with better outcomes in the developing world

    Cultural variation in expressed emotion and its prognostic significance

    Variation in the content and form of hallucinations and delusions, and in the interpretation of such symptoms, reflect differences in cultural context (e.g.,
    beliefs, settings)

Anxiety

    Occurs across culture, but differs in phenomenology, expression, and societal structuring

    Culture-bound syndromes – localized disorders or exaggerations of prototypic cultural behavior?

        Koro vs. Ataques de nervios

5 dimensions of cultures (Hostede, 2001)

    Individualism – Collectivism = autonomy and separateness vs. interdependence and integration

    Power Distance = perceived closeness vs. remoteness from the power elite

    Uncertainty Avoidance = seeking or evading contact with what is unfamiliar

    Masculinity – Femininity = orientation toward achievement vs. expression

    Short-term vs. Long-term Perspective = pursuit of immediate vs. delayed goals

5 cultural dimensions of psychopathology

    Individualism – Collectivism
    
        Alienation, guilt, narcissism
        Discord, shame, social phobia

    Power Distance

        Internal struggle
        Perception of failure

    Uncertainty Avoidance

        Amorphous vs. specific symptoms
        Lability vs. intellectualization

    Masculinity – Femininity

        Feeling inadequate
        Feeling misunderstood

    Dynamism (short-term vs. long-term)

        Insensitivity, impulsivity
        Over-accommodation, passivity

DISCUSSION:

➢    Is there a relationship between psychopathology and certain economic and political systems?

➢    Do you think that the rapid pace and sometimes unexpected pathways of social change (e.g., globalization) can increase some maladaptive symptoms and reduce others?