Chapter 14

Question 1

culture-bound syndromes

Answer 1

• Hikikomori
• dhat syndrome
• eating disorders
• koro
• amok
• hysteria
• frigophobia
• susto
• voodoo death
• latah
• malgri
• agonias
• kufungisisa
• ataques de nervios

Question 2

culture-bound syndromes: hikikiomori

Answer 2

• condition in which people have spent at least 6 months in an antisocial state, not participating in education or employment, having no intimate relationships with anyone outside immediate family, with onset before late 20s and unexplained by other psychiatric disorders
• Typically happens to male Japanese students

Question 3

culture-bound syndromes: dhat syndrome

Answer 3

• belief that one is leaking semen (associated with health/vitality), leading them to be morbidly anxious, often associated with strong shame about doing certain sexual acts (ie. masturbation)
• frequently observed in South Asian cultures

Question 4

culture-bound syndromes: eating disorders

Answer 4

• Common in North America, particularly among female college students
• • Bulimia nervosa: characterized by binge eating and induced vomiting; must recurrently binge and purge at least twice a week for 3 months, have self-evaluation impacted by body weight, and not have anorexia
• – Culture-bound syndrome that’s more common in places that have been exposed to Western cultural influences
• • Anorexia nervosa: refusing to maintain a normal body weight, be intensely fearful of gaining weight, deny seriousness of low body weight, and miss 3 periods
• – Anorexia is an existential universal (appears in many cultures), but is not a functional universal (self-starvation associated with different motivations - ie. being thin vs. being spiritual)

Question 5

culture-bound syndromes: koro

Answer 5

• A fear that one’s penis is shrinking into one’s body, which is believed to lead to harmful consequences including death
• Common among men in South and East Asia (although can also be experienced by women, who believe nipples are shrinking into body)

Question 6

culture-bound syndromes: amok

Answer 6

• An acute outburst of unrestrained violence associated with indiscriminate homicidal attacks, preceded by a period of brooding and ending with exhaustion and amnesia
• Primarily occurs in Southeast Asian males

Question 7

culture-bound syndromes: hysteria

Answer 7

• Experiencing fainting, paralysis, insomnia, temporary blindness, loss of appetite for food or sex, and tendency to cause trouble
• Historically common in European women

Question 8

culture-bound syndromes: frigophobia

Answer 8

• Morbid fear of catching a cold, leading people to dress in heavy coats and scarves, even in summer
• Common in China

Question 9

culture-bound syndromes: susto

Answer 9

• Feeling that a frightening experience has caused one’s soul to get dislodged from one’s body
• Common in Latin America

Question 10

culture-bound syndromes: voodoo death

Answer 10

• Being convinced that a curse has been placed upon them or they’ve broken a taboo, leading to a severe fear reaction that sometimes leads to their own deaths
• Common in Africa

Question 11

culture-bound syndromes: latah

Answer 11

• Falling into a transient dissociated state after some kind of startling event, such as thinking they’ve seen a snake; usually exhibiting unusual behaviour like barking, yelling sexually charged statements, etc. and retaining no memory of this
• Common in Southeast Asia, Siberia, and Japan

Question 12

culture-bound syndromes: malgri

Answer 12

• Territorial anxiety; when one enters new territory without engaging in the appropriate ceremonial procedures, it is believed that one is invaded by a totemic spirit that makes one physically sick, tired, and drowsy
• Common amongst Australian aboriginal groups

Question 13

culture-bound syndromes: agonias

Answer 13

• Anxiety disorder with symptoms such as burning sensation, loss of breath, hysterical blindness, sleeping, and eating disorders
• Common amongst Portuguese and Azoreans

Question 14

culture-bound syndromes: kufungisisa

Answer 14

• Associated with anxiety and somatic problems thought to stem from mental exhaustion; mind has been damaged by excessive thinking, leading to panic attacks and irritability
• Common in Africa, Caribbean, East Asia, and Native Americans

Question 15

culture-bound syndromes: ataques de nervios

Answer 15

• Emotionally charged settings like funerals lead to palpitations, numbness, and sense of heart rising into the head
• Common in Puerto Rico

Question 16

4 universal syndromes

Answer 16

• depression
• social anxiety disorder
• suicide
• schizophrenia

Question 17

universal syndromes: depression

Answer 17

• Depression is universal, but there are differences in prevalence of psychological vs. physiological symptoms of depression
• • Somatization: experiencing symptoms primarily in their bodies
• • Psychologization: experiencing symptoms primarily in their minds

Question 18

universal syndromes: social anxiety disorder

Answer 18

• The fear that one is in danger of acting in an inept and unacceptable manner, resulting in disastrous social consequences, leading them to avoid social-anxiety-inducing situations
• Universal, but more prevalent in cultures that emphasize fitting in with others (ie. East Asian contexts - saving face, social harmony)
• • However, less likely to be diagnosed in East Asia because people are less concerned about those symptoms → more in-line with Asian norms compared to Western ones

Question 19

taijin kyoufushou (TKS)

Answer 19

disorder identified in Japan that’s similar to social anxiety (fear elicited by social situations), but different symptoms (somatic symptoms like blushing, body odor, sweating, and concern with how uncomfortable these will make others feel)

Question 20

universal syndromes: suicide

Answer 20

Exists in all cultures, but with varying frequency (some places that are very religious have almost no suicide, whereas in other cultures it’s become almost ritualized - ie. in Japan, there’s an idea of committing suicide to take responsibility and preserve one’s honour)

Question 21

universal syndromes: schizophrenia

Answer 21

• 2 or more of the following: delusions, hallucinations, disorganized speech, grossly disorganized or catatonic behaviour, and negative symptoms (ie. flat mood)
• Has clear biological basis and is therefore present across cultures, but there’s variation in the subtypes
• • Paranoid schizophrenia (characterized by delusions) was most common subtype in most locations
• • Catatonic schizophrenia (characterized by near absence of motor activity and insensitivity to external stimuli) rarely observed in the West but common in India

Question 22

mental health treatment

Answer 22

• different approaches to treatment across cultures

- this includes social support, types of support offered, and types of therapies

Question 23

mental health treatment: social support

Answer 23

• more commonly sought-out amongst European-Americans compared to East Asians or Asian-Americans, who are more concerned about how seeking this support will make them appear
• • Asians also more likely to rely on implicit social support - reminding themselves of the close relationships they have

Question 24

mental health treatment: types of support offered

Answer 24

North Americans offer more emotional support to friends, whereas Asians tend to offer problem-focused support → may explain why Asians less likely to see a therapist

Question 25

mental health treatment: types of therapies - Morita and Naikan in Japan

Answer 25

• Morita: doesn’t try to change client’s anxious or depressive symptoms; rather, tries to change the person’s perspective on the symptoms so they see them as a natural part of who they are and can still live productively
• Naikan: shows clients suffering from addiction, depression, and sociopathy how indebted they are to the kindness of significant others; gives them insight into their past so they can reinterpret it and give new meaning to their lives

Question 26

cultural competence

Answer 26

• Important for therapists working with people from different cultures
• Elements of cultural competence:
• • Recognize your own cultural influences so you can deal with your own projections onto other cultures
• • Develop knowledge about clients’ cultural background
• • Develop appropriate skills to intervene in therapy in a way that’s culturally sensitive and relevant