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Lecture PowerPoint Slides

By Benjamin Cheung

Cultural Psychology Third Edition

Steven J. Heine

Chapter 14—Mental Health

Chapter Objectives

 In this chapter, you will:

• Understand what makes a condition a psychological disorder • Define culture-bound syndromes • Identify various culture-bound syndromes • Differentiate between different forms of eating disorders • Identify various universal syndromes • Discuss the relationship between neurasthenia and depression • Explain cultural differences in the presentation of depression • Explain a psychological paradox involving cross-cultural

prevalence of social anxiety disorder • Differentiate between social anxiety disorder and taijin

kyoufushou

Chapter Objectives

 In this chapter, you will:

• Understand explanations behind suicide rates across various cultures

• Explain the biological heritability of schizophrenia • Differentiate between different forms of schizophrenia • Explain the disparity between the prognosis of schizophrenia in

industrialized versus less-developed societies • Understand cultural differences in social support seeking

behavior • Differentiate among different therapeutic approaches • Discuss the importance of cultural competence amont mental

health practitioners • Relate certain psychological disorders to degrees of universality

Overriding Themes in This Chapter

 While some psychological disorders are universal, many are seen only in specific cultures.

 Culture plays a role in the triggers and the manifestation of psychological disorders, even universal ones.

What Counts as a Disorder?

 Psychological disorders are defined as rare behaviors that somehow impair the individual. • Problem: What type of impairment is

problematic, and what if a behavior that is rare in one context is not rare in another?

• Indeed, some psychopathologies are more prevalent, or manifest in highly different forms, across cultures.

What Counts as a Disorder?

 Culture-bound syndromes • Disorders greatly influenced by cultural factors • Occur far less frequently in some cultural

contexts

Presenter

Presentation Notes

Culture-bound syndromes are disorders that are greatly influenced by cultural factors, and occur far less frequently in some cultural contexts.

Culture-Bound Syndromes

 Experiencing a culture-bound syndrome generally requires one to have cultural beliefs associated with the syndrome. • E.g. South Asian men may suffer from dhat

» Being susceptible to dhat requires that the person have the relevant beliefs that relate semen, sexual activity, morality, and health.

Presenter

Presentation Notes

Dhat is a morbid anxiety seen most frequently among South Asian males that they are losing or leaking semen, and it is believed that loss of sperm results in the person getting seriously ill. This often results from anxieties about disapproved sexual acts such as masturbation. This “dhat” would be a meaningless label in the United States, however, where there are no cultural beliefs about the vitality that sperm endows, and no cultural beliefs about the consequences of loss of sperm. Is it possible that other cultures suffer from the same psychological disorders as the West but don’t have the same cultural beliefs associated with Western diagnoses, making them meaningless in other cultural contexts?

Culture-Bound Syndromes

 Hikikomori • Patient drops out from the social word, barricading

his- or herself up in a room for years. » Indicates the cause may be failure to succeed in a social

world that has few options for those who don’t fit in • Does not conform to criteria for any DSM-IV-R

diagnoses • Approximately one child per classroom in junior high

and high school is afflicted. • Largely not existent in pre-war in Japan, and

uncommon in other cultures.

Presenter

Presentation Notes

Hikikomori A condition in Japan characterized by living in an asocial state, with no intimate relationships with anyone outside of the immediate family. First appears in junior high, and they end up reading books, watching TV, or playing games in their rooms. Indicates the cause may be failure to succeed in a social world that has few options for those who don’t fit in. Does not conform to criteria for any DSM-IV-R diagnoses. It has only recently become a cultural phenomenon, and is now seen (although rarely) in other East Asian countries.

Culture-Bound Syndromes

 Bulimia Nervosa • Bulimia—uncontrollable binge eating;

individual then takes inappropriate measures to prevent weight gain

» Absent in most cultures of the world, making it a culture-bound syndrome (especially in cultures where food is not abundant)

Presenter

Presentation Notes

Eating disorders affect many people in the West, but there are some nuances when it comes to determining universality of these conditions. We will focus on bulimia nervosa and anorexia nervosa. Bulimia nervosa is a disorder characterized by binge eating and induced vomiting Bulimia appears to be a culture-bound syndrome because rates have increased over time, and the age of people being diagnosed with bulimia has gotten lower over the years. It is also more prevalent in some societies (particularly those with Western influences) than others. In particular, it is absent in most cultures of the world, especially in cultures where food is not abundant. There is good evidence that bulimia is a culture-bound syndrome.

Culture-Bound Syndromes

 Anorexia Nervosa • Anorexia—an individual’s refusal to maintain

normal body weight due to preoccupation with their body.

» Evidence of culture-bound status: Huge increase in rates of anorexia this century; primarily found in only some cultures

» Evidence of universality: Reports of self-starvation in numerous cultural contexts but not due to body image

Presenter

Presentation Notes

Anorexia nervosa is a disorder in which, among other symptoms, one refuses to maintain a normal body weight, and is irrationally fearful of gaining weight or becoming fat. Anorexia is a little more complicated. As with bulimia, rates of anorexia have significantly increased over time, and it is absent in many cultures. However, it has been found in cultures that have very little Western influence, and it also manifests differently in some other contexts as well. Symptoms resembling anorexia have also been noted among ascetics who refused food for religious reasons, and in the 17th and 18th century among teenage girls who starved themselves to model themselves after the ascetics. This historical record of anorexia, as well as evidence if anorexia in many non-Western contexts, have led some to argue that it is a universal disorder, although it may serve different functions in different places (e.g., religious reasons versus weight-loss reasons).

Culture-Bound Syndromes

 Koro • Morbid anxiety about one’s penis shrinking

into one’s body • Primarily found in South and East Asia • It is unclear what aspects of culture have led

to the emergence of koro. • Koro-like symptoms have been found in some

individuals in West African cultures, as well as in individuals in American culture who have had negative marijuana-induced experiences.

Culture-Bound Syndromes

 Amok • Acute outburst of unrestrained violent and

homicidal attacks, preceded by brooding, followed by exhaustion and amnesia

• Most common in Southeast Asia • May result from having no acceptable means

to express frustration

Presenter

Presentation Notes

An interesting end to this discussion is to draw parallels between this and Western mass homicidal attacks (e.g. school shootings, workplace killings, etc.), but make the distinction that Western ones are premeditated.

Culture-Bound Syndromes

 Hysteria • A commonly diagnosed condition in 19th-

century Europe among women. • Symptoms include temporary blindness,

insomnia, fainting, and loss of appetite for food and sex.

• Rates of hysteria diagnosis dropped dramatically in the early 20th century.

Presenter

Presentation Notes

Hysteria A commonly diagnosed condition in 19th-century Europe among women. Symptoms include temporary blindness, insomnia, fainting, and loss of appetite for food and sex. Rates of hysteria diagnosis dropped dramatically in the early 20th century. Some think this is due to it’s being replaced by other diagnostic categories, while others think that it was associated with repressive Victorian cultural norms.

Culture-Bound Syndromes

 Other culture-bound syndromes: • Frigophobia—morbid fear of catching cold

» Found largely in China » People avoid cold air, eating cold food, dress with

several layers

Culture-Bound Syndromes

 Other culture-bound syndromes: • Susto—a frightening condition in which a

person thinks their soul has been caused to become dislodged from their body, causing a variety of physical and psychological symptoms

» Primarily found in Latin America

Culture-Bound Syndromes

 Other culture-bound syndromes: • Voodoo death—person is convinced a curse

has been placed on him/her, or s/he has broken a taboo

» Results in severe fear reaction, which may lead to death

» Mostly found in Africa.

Culture-Bound Syndromes

 Other culture-bound syndromes: • Latah—a transient dissociated state brought

on by a startling event, followed by engaging in cultural inappropriate behavior, after which the person has no memory of the episode

» Found primarily in Southeast Asia, but also in Siberia and amongst the Ainu in Japan

Culture-Bound Syndromes

 Other culture-bound syndromes: • Malgri—a concern that one has been invaded

by a totemic spirit that makes them sick, tired, and drowsy because they entered the sea or a new territory without having engaged in the appropriate ceremonial rituals.

» Identified among Aboriginal Australians • Agonias—an anxiety disorder that includes a

burning sensation, loss of breath, and sleeping, among other symptoms.

» Primarily found in Portugal and the Azores.

Presenter

Presentation Notes

Malgri – a concern that one has been invaded by a totemic spirit that makes them sick, tired, and drowsy because they entered the sea or a new territory without having engaged in the appropriate ceremonial rituals. Identified among Aboriginal Australians. Agonias – an anxiety disorder that includes a burning sensation, loss of breath, and sleeping, among other symptoms. Primarily found in Portugal and the Azores.

Culture-Bound Syndromes

 Other culture-bound syndromes: • Kufungisisa—anxiety and somatic problems

associated with mental exhaustion, stemming from too much thinking.

» Primarily found in Africa, Caribbean, Native Americans, East Asia.

• Ataques de nervios—feeling palpitations, numbness, and a rising heat sensation during emotionally charged situations such as funerals.

» It has been found in Puerto Rico.

Presenter

Presentation Notes

Kufungisisa – anxiety and somatic problems associated with mental exhaustion, stemming from too much thinking. Africa, Caribbean, Native Americans, East Asia. Ataques de nervios – feeling palpitations, numbness, and a rising heat sensation during emotionally charged situations such as funerals It has been found in Puerto Rico.

Universal Syndromes

 Universal syndromes highlight the biological bases of these psychopathologies

• Still, prevalence and manifestations of these disorders may differ across cultures

Presenter

Presentation Notes

Universal syndromes highlight the biological bases of these psychopathologies. Still, prevalence and manifestations of these disorders may differ across cultures.

Universal Syndromes

Diagnosed given 5 of following 9 symptoms:

Depressed mood

Inability to feel pleasure

Change in weight/ appetite

Sleep problems

Psychomotor change

Fatigue or loss of energy

Feeling worthless

Poor concentration Suicidality

Major Depressive Disorder (MDD)

Presenter

Presentation Notes

DSM-5: Major Depressive Disorder (MDD) diagnosed given 5 of following 9 symptoms: Depressed mood Inability to feel pleasure Change in weight or appetite Sleep problems Psychomotor change Fatigue or loss of energy Feeling worthless or guilty Poor concentration Suicidality

Universal Syndromes

 MDD has been found in all cultures that people have studied • Prevalence rates appear to vary

» Depression prevalence rates vary in the United States based on diagnostic criteria; the rate in China is about one-fifth that observed in the West.

Presenter

Presentation Notes

MDD has been found in all cultures that people have studied, although prevalence rates appear to vary. Depression prevalence rates vary in the United States based on diagnostic criteria; the rate in China is about one-fifth that observed in the West. One proposed rationale for this is due to two different manifestations of symptoms: Somatization (symptoms are primarily physiological, such as loss of appetite) Psychologization (symptoms are primarily psychological, such as depressed mood)

Universal Syndromes

 Many Chinese psychiatric patients are diagnosed with neurasthenia. • Neurasthenia = poor appetite, headaches, insomnia,

inability to concentrate • Neurasthenia was dropped from the DSM because

symptoms were more physiological than psychological.

 Some have argued that most Chinese neurasthenia actually qualify for depression, even if only 9% of them report feeling depressed.

Presenter

Presentation Notes

Many Chinese psychiatric patients are diagnosed with neurasthenia. Neurasthenia = poor appetite, headaches, insomnia Neurasthenia was dropped from the DSM because symptoms were more physiological than psychological, but both types of patients respond well to antidepressants. Some have argued that most Chinese neurasthenics actually qualify for depression, even if only 9% of them report feeling depressed. What is the relationship between these two conditions?

Universal Syndromes

Presenter

Presentation Notes

A variety of research methodologies have converged on the same finding that Chinese patients exhibit more physiological symptoms than psychological symptoms. This is certainly the case with depression. Why do you think this is the case? One explanation is a concern about stigma – everyone experiences the psychological symptoms, but Chinese people are less likely to report them due to fear of being stigmatized, although little data support this assertion. The second explanation suggests that Westerners are more likely to focus on, and notice, psychological symptoms. On the other hand, East Asians are more likely to attend to their physiological symptoms, thus reporting more of these, despite both types of symptoms existing for both cultural groups. Data seem generally to support this explanation.

Universal Syndromes

 Social Anxiety Disorder = a fear of acting in an inept and unacceptable manner, leading to negative social consequences • Research has shown that East Asians exhibit

more social anxiety symptoms than European-Americans.

» Accordingly, evidence suggests that interdependence is associated with heightened social anxiety.

» However, social anxiety is less documented in East Asian countries.

Presenter

Presentation Notes

Social Anxiety Disorder = a fear of acting in an inept and unacceptable manner, leading to negative social consequences. It has been documented universally but, counterintuitively, it is LESS documented in East Asian countries than in North American countries, despite greater concerns about social harmony and maintaining face in East Asia. Certainly, East Asians exhibit greater social anxiety symptoms, and there is some link between interdependence and social anxiety symptoms. In general, though, the rates of social anxiety disorder in North America and Europe are 14 times higher than rates in East Asia. Why might this be?

Universal Syndromes

 The paradox between East Asians experiencing more symptoms, but not meeting clinical criteria for social anxiety disorder may be due to differences in what behaviors are considered culturally normative. • In Western cultures, the norm is for people to

be extraverted. • In East Asian cultures, the norm is for people

Universal Syndromes

 There is a culture-bound disorder found in East Asian countries that is similar to social anxiety disorder. • taijin kyoufushou = “Fear of confronting

others” » Solicited by social situations » Extreme concern that one is making others

uncomfortable due to one’s gaze, body odor, or sweating.

Presenter

Presentation Notes

That’s not to say that social anxieties do not become a problem in East Asian cultures. There is a culture-bound disorder called taijin kyoufushou, or a fear of confronting others. It is a fear that is solicited by social situations, such that one is concerned about how uncomfortable one makes other people feel, perhaps because of their gaze, body odor, or sweating. It similar to social anxiety disorder because it is effectively treated using the same antidepressant as is used to treat social anxiety disorder. It has thus far been limited to Japan, China, and South Korea.

Universal Syndromes

Presenter

Presentation Notes

Suicide rates vary dramatically around the world. Eastern Europe tends to have the highest rates. Muslim nations tend to have the lowest. Suicide rates also vary depending on one’s age, with the elderly generally being more likely to commit suicide in most cultures. There is a special case in Micronesia, in which there is a spike in the adolescent age group. This started primarily in the 1970s when a spate of suicides occurred among adolescent men over seemingly trivial problems, with no obvious psychological issues to begin with. These suicides were also restricted to specific islands, particularly the suburban regions of those islands. Some have suggested that this spike was due to Westernization of the island, leading to a loss of traditional roles for young men.

Universal Syndromes

 Losing connection between one’s cultural narrative and modern society (lack of cultural continuity) seems to put people at risk for suicide.  Many First Nations bands do not have a

strong sense of cultural continuity due to Western colonization. • Many youths cannot identify with their

traditional culture and are also unable to identify with mainstream Canadian culture.

Presenter

Presentation Notes

Similar concerns have been raised among many native populations in Westernized nations, such as the First Nations bands in Canada. The suicide rates of First Nations adolescents is five times that of mainstream adolescents. Why do you think that is?

Universal Syndromes

 Support for this argument has come from findings that bands with stable connections to traditional cultural past have lower suicide rates.

 Such a connection is indicated by: • Negotiating a land claim with the government • Possessing self-government • Maintaining control over educational services • Controlling their police and fire services • Managing health services and cultural facilities

 The more these indicators are present, the lower the suicide rate.

Presenter

Presentation Notes

One fundamental hypothesis that researchers have found support for is that the lack of connection to one’s cultural roots is a strong predictor of suicide rates. This is compounded by the fact that many do not identify with the mainstream Canadian culture. Indeed, research has found that the more that First Nations communities can connect with their cultural history, the lower their suicide rates are. The communities that have the most number of connections have suicide rates that are comparable with those of mainstream Canada. These connections include having its own policing or law enforcement organization, cultural facilities that promote a community’s cultural history, having one’s own political body, and whether or not a community is negotiating a claim to territorial land.

Universal Syndromes

 Despite the universal prevalence of suicides: • Prevalence rates still differ dramatically

across cultures. • Motivations for suicide also vary greatly

across cultures. » Motivations in the West usually include substance

abuse or depression; motivations in Japan often deal with one accepting responsibility and/or preserving honor.

Presenter

Presentation Notes

The cases of the First Nations and Micronesia suggest that different cultures have different motivations for suicide, and it may carry different meaning in different cultures. For instance, Japan has a long history of suicide playing an unusually significant role, with the ritualized suicide method of “seppuku.”

Universal Syndromes

 Schizophrenia • One of the most debilitating mental disorders,

and universally found around the world • There are relevant genetic factors, prenatal

experiences, and neuroanatomical features. • Diagnosed given 2 or more of the following:

Delusions Hallucinations Disorganized speech

Catatonic behavior

Negative symptoms

Presenter

Presentation Notes

Schizophrenia is a disorder that is diagnosed when one exhibits two or more of these symptoms: delusions, hallucinations, disorganized speech, catatonic or grossly disorganized behavior, and negative symptoms such as flat affect or loss of speech. Lecture Suggestion: After talking about the relevant biological precursors/signs of schizophrenia, talk about how the biological basis of schizophrenia is better understood than other mental disorders.

Universal Syndromes

 Good evidence of a genetic component for schizophrenia • One’s likelihood of developing schizophrenia

increases as the degree of genetic relatedness with someone who has schizophrenia increases

 Despite its biological basis and similar incidence rates across cultures, some cultural variation still exists.

Presenter

Presentation Notes

There is good evidence of a genetic component to schizophrenia because one’s likelihood of developing schizophrenia increases as the degree of genetic relatedness with someone who has schizophrenia increases. That is, only 1% of the general population will develop schizophrenia. Having a cousin with the disorder leads to a likelihood of 2%, having a sibling with schizophrenia increases the likelihood to 9%, and having an identical twin increases the likelihood to 48%. As one would expect with something that has a biological basis, incidence and prevalence rates are quite similar across different cultures. But notice that, despite the role of genetics, there is still more than 50% chance that someone would not develop schizophrenia even if their identical twin (with whom one shares 100% of genes) has schizophrenia.

Universal Syndromes

 Subtypes of schizophrenia vary substatially:

» West: Rate of paranoid schizophrenia as high as 75%; rate of catatonic schizophrenia 1-3%

» India: Rate of paranoid schizophrenia as high as 15%; rate of catatonic schizophrenia 20%

Presenter

Presentation Notes

One note of caution with interpreting the cross-cultural similarity in prevalence rates, though, is that people were excluded if they did not meet the specific criteria for schizophrenia despite experiencing psychoses. This means that the similarity we see is likely an artifact of the diagnostic criteria that we use. One important line of evidence suggesting the role of culture is in the cultural variability in the prevalence rates of different subtypes of schizophrenia that people experience. For instance, paranoid schizophrenia characterized 75% of cases in the UK. In contrast, catatonic schizophrenia is rarely seen in the West, with a prevalence rate of approximately 1%–3% in the U.S. and the UK; but India has a prevalence rate of approximately 20%.

Universal Syndromes

 Also, patients in less-developed societies have greater rate of recovery than in more industralized societies. • This is the opposite of what one sees with

other physical and mental pathologies. • Cause of this difference is unknown.

» Some suggest that patients are more likely to remain members of a community in such societies, rather than becoming homeless in industralized societies.

Presenter

Presentation Notes

Interestingly, patients in less-developed societies have greater rates of recovery from schizophrenia than in more industrialized societies, which is the opposite of what one sees with other physical and mental conditions. Explanations for this counterintuitive pattern include laying less blame on the patient due to his/her having less of a primary sense of control, having more positive associations with what the West considers to be hallucinations, and greater involvement of the community so that the person does not get left alone.

Treatments

 Just as presentation and prevalence of psychological disorders vary across cultures, the same goes for how the disorders are treated.

 There is a tradition in the West of patients seeing a therapist and verbalizing their feelings and problems. • Likely rooted in the Western emphasis on self-

expression and being in a low-context culture, among many other ideas discussed in this course

 There is cultural variation in coping and seeking support.

Presenter

Presentation Notes

Just as presentation and prevalence of psychological disorders vary across cultures, the same goes for how the disorders are treated. There is a tradition in the West of patients seeing a therapist and verbalizing their feelings and problems. This is likely rooted in the Western emphasis on self-expression and being in a low-context culture, among many other ideas discussed in this course, and ignores non-Western ideas of not attending to emotions and private feelings, and that people don’t actually talk about their troubles to others. There is great cultural variation in coping and seeking support.

Treatments

 East Asians are less likely than European- Americans to actively seek social support. • This is due to concerns about how this will

disrupt relationships with others. • Instead, they rely on implicit social support—

reminding themselves of the close relationships that they have.

• This may explain why East Asians tend to seek professional mental health treatment less than Westerners.

Presenter

Presentation Notes

For instance, one important difference is with social support. Research has suggested that social support is good for one’s health, regardless of cultural background, but East Asians are less likely than European Americans to actively seek social support. This is due to concerns about how this will disrupt relationships with others. Instead, they rely on implicit social support— reminding themselves of the close relationships that they have. Whereas European Americans show less stress when they seek help, Asian Americans show less stress when they think about their relationships. This may explain why East Asians tend to seek professional mental health treatment less than Westerners do.

Treatments

 Western treatment traditions can be traced back to Freudian times. • Psychological problems are best treated by

exploring people’s memories and experiences.

• As treatment has extended into modern times, there is an emphasis on understanding the individual, his/her self-discovery, and his/her cognitive biases.

Presenter

Presentation Notes

Western treatment traditions can be traced back to Freudian times. Freud thought that psychological problems were best treated by exploring people’s memories and experiences because such problems were believed to be rooted in in people’s conflicts at an unconscious level, and the therapist should then interpret those experiences and memories. Carl Rogers then introduced the client-centered approach, and other biological modes of thought have since been developed as well; but the common thread running through all the different therapy options is the client’s ability to engage with the therapist.

Treatments

 In contrast to the Western style, two broad categories of treatments can be seen elsewhere. • Family-centred

» Families seen as a key source of guidance and play an important role in treatment.

• Spiritualism and religion » Construing psychological disorders as a problem

with one’s spirituality or a relationship with god(s) that went awry.

Presenter

Presentation Notes

In other cultures, healing practices are performed very differently. One of the most common practices is the role of families – they share the problems with the individual, and also share the stigma and blame associated with whatever mental illness the individual has. Another common practice involves spiritualism and religion, which incorporates traditional healers such as shamans and sorcerers.

Treatments

 Japan has a couple of unique approaches to psychotherapy • Morita therapy to treat depression and anxiety

symptoms » Emphasizes secondary control

• Naikan therapy to treat people with depression and addiction problems

» Asks clients to reflect on the kindness they have received from others and how little they have offered in return

Presenter

Presentation Notes

Japan also has a couple of unique approaches to psychotherapy that reflect the cultural inclinations of Japan. The two are called Morita therapy and Naikan therapy. Morita therapy is used to treat depression and anxiety symptoms. It does so by emphasizing secondary control, asking clients to accept the circumstances of their lives. Client must change their perspectives of the symptoms and learn to live productively in spite of those symptoms. To live productive lives, the treatment plan involves light manual activities (such as sweeping), heavy manual labor (such as chopping wood), and other forms of life training. Naikan therapy is used to treat people with depression and addiction problems. Clients are asked to reflect on their past, particularly on the kindnesses that they had received from others, while thinking about how little they have offered in return for those kindnesses.

Treatments

• Given the cultural diversity in prevalence rates of psychopathologies, one concern that has been raised is whether Western mental health treatments may sometimes do more harm than good.

Presenter

Presentation Notes

Given the cultural diversity in prevalence rates of psychopathologies, one concern that has been raised is whether Western mental health treatments may sometimes do more harm than good. For instance, it’s been argued that anorexia did not exist in the same form in Hong Kong until it was imported there. Similarly, post- traumatic stress disorder was not a big problem in Sri Lanka after the 2004 tsunami until Western aid workers insisted that they must be suffering from it.

Treatments

 Striving for cultural competence • Recognize own cultural influences • Understand client’s cultural background • Develop skills to intervene in a culturally

sensitive manner • Be flexible and adapt to the client’s

individual needs. » Cultural consultation service, an interdisciplinary

approach involving many different mental health professionals.

Treatments

Presenter

Presentation Notes

Therapists who work with clients from different cultural backgrounds should strive for cultural competence – that is, therapists should recognize their own cultural influences so that they are aware of their own thought processes when dealing with clients; therapists should develop knowledge about the client’s cultural background so that they can better understand the kinds of expectations the client likely has for the counseling relationship; and therapists should develop skills to intervene in the therapy sessions in a way that is culturally sensitive and relevant. Having said that, therapists need to be flexible and adapt to the individual needs of the client, as not everyone is typical of their culture, and several cultural identities may intersect in some people. The most current and comprehensive approach thus far is called the cultural consultation service, which is an interdisciplinary approach involving psychiatrists, psychologists, social workers, psychiatric nurses, medical anthropologists, and trainees from different disciplines. This group meets regularly to discuss particular cases of multicultural clients to tackle a variety of issues that therapists would generally not recognize or be ready to handle, such as migration stresses and exposure to torture or war. Unfortunately, this service is very expensive.

Summary

 Some psychological disorders are concentrated in specific cultural groups, while others can be found worldwide.  Even the same psychological disorder can

manifest (and be experienced) in different ways in different cultures.  Treatments for psychological disorders

differ across cultures and often take on the traditions of a particular culture.

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Chapter Objectives
Chapter Objectives
Overriding Themes� in This Chapter
What Counts as a Disorder?
What Counts as a Disorder?
What Counts as a Disorder?
Culture-Bound Syndromes
Culture-Bound Syndromes
Culture-Bound Syndromes
Culture-Bound Syndromes
Culture-Bound Syndromes
Culture-Bound Syndromes
Culture-Bound Syndromes
Culture-Bound Syndromes
Culture-Bound Syndromes
Culture-Bound Syndromes
Culture-Bound Syndromes
Culture-Bound Syndromes
Culture-Bound Syndromes
Universal Syndromes
Universal Syndromes
Universal Syndromes
Universal Syndromes
Universal Syndromes
Universal Syndromes
Universal Syndromes
Universal Syndromes
Universal Syndromes
Universal Syndromes
Universal Syndromes
Universal Syndromes
Universal Syndromes
Universal Syndromes
Universal Syndromes
Universal Syndromes
Treatments
Treatments
Treatments
Treatments
Treatments
Treatments
Treatments
Treatments
Summary