Culture and psychological distress (original) (raw)
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Transcultural Psychiatry, 2019
The term ‘‘cultural concepts of distress’’ (CCD) was introduced in DSM-5 to better characterize the broad set of constructs identified in clinical and ethnographic research on cultural variations in distress. The contributions to this issue of Transcultural Psychiatry on cultural concepts of distress show how much work on this topic has evolved and equally what remains to be done. In this Commentary, we take stock of the current state of the field and outline some future directions for research and clinical application.
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.
Culture and Mental Health: Sociocultural Influences, Theory, and Practice
International Journal of Health Care Quality Assurance, 2009
Culture and Mental Health takes a critical look at the research pertaining to common psychological disorders, examining how mental health can be studied from and vary according to different cultural perspectives. Introduces students to the main topics and issues in the area of mental health q using culture as the focus Emphasizes issues that pertain to conceptualization, perception, health-seeking q behaviors, assessment, diagnosis, and treatment in the context of cultural variations Reviews and actively encourages the reader to consider issues related to q reliability, validity and standardization of commonly used psychological assessment instruments among different cultural groups Highlights the widely used DSM-IV-TR categorization of culture-bound q syndromes Download Culture and Mental Health: Sociocultural Influence ...pdf
Social Science & Medicine, 2017
Depression is a major focus of concern in global mental health, with epidemiological surveys indicating high prevalence rates worldwide (Ferrari et al., 2013a). Estimates of the global burden of depression in terms of disability, quality of life, and economic impact have been used to argue for scaling up the detection and treatment of depression as a public health and development priority in low and middle-income countries (Chisholm et al., 2016; Patel, 2017). These projections, however, are based on limited data and make many assumptions about the generalizability of findings across populations. While epidemiological research suggests there is substantial cross-cultural variation in the prevalence and symptomatology of depression (Ferrari et al., 2013b; Kessler & Bromet, 2013), there is evidence that a syndrome similar to major depressive disorder can be identified across diverse cultural contexts (Kirmayer & Jarvis, 2006; Steel et al., 2014). In a useful contribution, Haroz and colleagues (this issue) reviewed the qualitative literature on cultural variations in depression to gauge the extent to which current diagnostic criteria fit the experience of people in diverse contexts. They found significant cultural variation and call for an expanded research program to explore the meaning and significance of these cultural differences for our understanding of mental health. This is crucial for current efforts to address global inequities in mental health and to make sense of claims of a global "epidemic" of depression (Baxter et al., 2014).
Culture, cultural factors and psychiatric diagnosis: review and projections
World psychiatry : official journal of the World Psychiatric Association (WPA), 2009
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...
In the past decade anthropologists working the boundary of culture, medicine, and psychiatry have drawn from ethnographic and epidemiological methods to interdigitate data and provide more depth in understanding critical health problems. But rarely do these studies incorporate psychiatric inventories with ethnographic analysis. This article shows how triangulation of research methods strengthens scholars' ability (1) to draw conclusions from smaller data sets and facilitate comparisons of what suffering means across contexts; (2) to unpack the complexities of ethnographic and narrative data by way of interdigitating narratives with standardized evaluations of psychological distress; and (3) to enhance the translatability of narrative data to interventionists and to make anthropological research more accessible to policymakers. The crux of this argument is based on two discrete case studies, one community sample of Nicaraguan grandmothers in urban Nicaragua, and another clinic-based study of Mexican immigrant women in urban United States, which represent different populations, methodologies, and instruments. Yet, both authors critically examine narrative data and then use the Center for Epidemiologic Studies Depression Scale to further unpack meaning of
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.