Culture and Mental Health: Sociocultural Influences, Theory, and Practice (original) (raw)
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This paper aims to provide conceptual justifications for the inclusion of culture and cultural factors in psychiatric diagnosis, and logistic suggestions as to the content and use of this approach. A discussion of the scope and limitations of current diagnostic practice, criticisms from different quarters, and the role and relevance of culture in the diagnostic encounter, precede the examination of advantages and disadvantages of the approach. The cultural content of psychiatric diagnosis should include the main, well-recognized cultural variables, adequate family data, explanatory models, and strengths and weaknesses of every individual patient. The practical aspects include the acceptance of "cultural discordances" as a component of an updated definition of mental disorder, and the use of a refurbished cultural formulation. Clinical "telescoping" strategies to obtain relevant cultural data during the diagnostic interview, and areas of future research (including...
Recent work on culture and psychopathology is beginning to unpack the cognitive, developmental and interactional processes through which social contexts shape illness onset, experience, course and outcome. New conceptual models, tools, and technologies, along with better data, lend support to an ecosocial view of mental disorders that emphasizes the way that cultural contexts influence developmental processes and exposure to social adversity to increase risk for specific types of psychopathology. This contextual view has implications for research design and clinical practice. Recognizing the importance of culture, DSM-5 now includes a discussion of cultural concepts of mental disorders as well as a Cultural Formulation Interview to help clinicians explore the context of mental health symptoms and disorders.
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Mental disorder and cross-cultural psychology
Clinical Psychology Review, 1999
The predominant Western approach to understanding mental disorder, as indicated in the Diagnostic and Statistical Manual of Mental Disorders (DSM) , is based on a biomedical perspective which sees mental disorders as "natural kinds" or discrete entities which manifest as dysfunction within individuals. Following from this is the view that the DSM 's primary syndromes are universal, based on the assumption that this dysfunction is similar across diverse human populations. The cross-cultural literature, however, reveals significant differences in the manifestation of these syndromes across ethnic groups, thereby challenging the universalist position. In response to this shortcoming of the predominant contemporary conceptualization of mental disorder, a constructivist approach is offered which, it is argued, has a number of important advantages over the traditional view. Finally, the implications of a constructivist definition are discussed, demonstrating the important connection between theory and practice. © 1999 Elsevier Science Ltd THE NATURE OF mental disorder has been the focus of fierce debate over the last 100 years and has generated a number of different theoretical perspectives and research programs. However, researchers remain unclear about the mechanisms generating the majority of psychological disorders and problems, and dispute the degree to which mental disorders represent illnesses, adaptational difficulties, or social disruption. At the heart of this debate is a lack of clarity concerning the relationship between mental disorder and sociocultural factors. Are mental disorders primarily diseases requiring diagnosis and treatment just as purely physical conditions are? Or alternatively, do they represent a lack of attunement between individuals and their social environment? Both these viewpoints have quite different implications for research and treatment, and for the understanding of the relationship between psychological distress and culture.
Frontiers in Psychiatry
The present paper discusses the role of culture in understanding and treating psychopathology. It describes new perspectives on the conceptualization of psychopathology and on the definition of culture, and how these are intertwined. The impacts of culture, explicit and implicit discrimination, and minority stress on mental health are reviewed, especially in the current era. Culturally-sensitive assessment practices in psychopathology are emphasized, including addressing the multiple cultural identities of the patient, the explanatory models of the experienced distress, specific psychosocial stressors and strengths, and the cultural features of the practitioner-patient relationship in the clinical encounter. The particular case of psychotherapy in working with culturally diverse patients is explored. Finally, mainstreaming of culture in research and clinical training in psychopathology is highlighted, acknowledging that each clinical interaction is a cultural one.