Cultural Issues Validity Diagnosis And The Dsm

Question 1

Culture doesn’t affect diagnosis mental disorders are scientific

Answer 1

The dsm was developed in the USA and is used widely in other cultures. This is a valid use if mental disorders are clearly defined with specific features and symptons for instance schizophrenia present as the same illness all over the world with particular symptoms and features
Mental disirrr are scientifically defined illnesses that explained in scientific way

Question 2

Culture does affect diagnosis a spiritual model

Answer 2

Studied have shown that culture can affect diagnosis. For example symptons that are seen in western countries as charaxterisubg schizophrenia can be interpreted in other countries as showing possession y spirits which renders someone special in a positive rather than negative disorder way.

Question 3

Evard 2014 writes about

Answer 3

Hearing voices can be because of a mental disorder but it can also be an individual difference and interpreted as 8bah expectional experience. Depending on cultural interpretations of what is being measured the dsm isn’t valid a clinical from one culture must be aware that a patient from another culture is guided by their own frame of reference

Question 4

Differences in how hallucinations are interpreted /understood

Answer 4

Luhrmann et al 2015 found that in the USA hearing voices was seen as a negative experience whereas in India and Ghana hearing voices was seen as a more positive. Suggests that the experience of a mental disorder might be different across cultures. If a patient is from a different culture to their clinancian cultural differences in what they say about their disorders might affect the children’s diagnosis this challenging the validity of diagnosis.

Question 5

Differences in how treatment affects people

Answer 5

Myers et al 2010 found from a case study that by using recovery model efforts to help people to become more empowered citizens tended to generate more stress for those diagnosed with schizophrenia if their lives are already stressful. This suggest that cultural differences can lead to different reactions to treatment. Myers caution against using the same model of treatment in all cultures and says that sicuoxiuktyrak conditions affect outcomes for those with schizophrenia. Outcomes are better in the developing world than in the USA and techniques to get better outcomes need to be locally relevant

Question 6

Outcomes for schizophrenia are better in the developing world

Answer 6

Kulhara et al 2008 reviewed studies and confirmed that there is a large propoetion of people having a good outcome for schizophrenia than in developing countries. This is cKkef the favourable out one hypothesis in developing countries. Kulhara says that other factors should be explored in research. With cultural differences come 9ther factors that might cause the differences in outcomes

Question 7

Catatonic schizophrenia is on

Answer 7

Decline and this could be because of health measures that prevent development of this type of schizophrenia. Chandeasena 1986 reported more incidences of catonia in Sri Lanka 21% compared to 5% among British people. However it was found that in Sri Lanka it was less likely that patients had received early interventions with drug treatment. Therefore not a cultural difference in the attitude to mental disorder but a difference in treatment availability

Question 8

Increased auditory hallucinations in Mexican born people than white Americans

Answer 8

Morevaudiriry hallucinations were reported to doctors by patients who were Mexican born Americans than those 2emho were non Mexican born Americans. The study by Burnham et al 1987 looked at this using self report and interviewing. Found that there was a difference no other explanation could be found so it was determined that culture led to difference

Question 9

Increases grandiosity in white Americans

Answer 9

White Americans reported grandiosity as a sympton compared with Americans of Mexican origin again showing cultural differences. Important to look for individual symptoms when looking for cultural differences in symptons of set of mental disorders because the dsm looks at a set of symptons

Question 10

Schizophrenia in all cultures has more

Answer 10

Similarities than differences. Lin et al 1956 summarised schizophrenia in all cultures and noted that is found in all cultures have been studied and the prevalence seems similar across all cultures. With regard to symptons similarities outweigh the differences. Good outcomes appear more likely in developed countries

Question 11

Evaluation of cultural differences in schizophrenia

Answer 11

It is important to note that just because the sympton under the heading schizophrenia appear similar and occur in all cultures it doesn’t mean that schizophrenia in all cultures is in fact the same illness with the same cause through the illness

Question 12

Less emphasis must be placed

Answer 12

On symptons that show cultural differences and more emphasis on symptons and feature that seem to be universal. For example something bizarre in one culture might not be bizarre in another culture. So bizarensss might be a sympton that has less emphasis placed on it when making a diagnosis using dsm

Question 13

Look at removing

Answer 13

Bizarre from list of symptons a warning of the need to be mindful of cultural differences that the judgement bizarre can entail. The dsm 5 has continued that warning

Question 14

One problem with schizophrenia is that first rank symptoms

Answer 14

Tend to be weighted as more important when making a diagnosis. First rank symptons include hearing voices delusions and other features of distortions in thinking. However first rank symptons are also open to more interpretation sju h means that there might be cultural issues with regard to interpretation

Question 15

Flaum et al 1991

Answer 15

Found a lack of reliability when using the dsm with regard to first rank symptoms and that was with a similar sample from one culture. Therefore it is likely that such un reliability would be magnified if using first rank symptons across different cultures. Minimising first rank symptoms ahd taking care with bizarre features would mean less un reliability with regard to diagnosis across cultures

Question 16

Focus more on objectively measured

Answer 16

With regard to diagnosis of schizophrenia there should be a greater emphasis on symptons that are objectively measured. Flaum et al 1991 suggest that negative symptoms are more objectively measured and assessed than positive symptons like hallucinations

Question 17

Culture bound syndromes are

Answer 17

Mental health problems with a set of symptons found and recognised as an illness in only one cjlgjtr. Many psychiatrists reject the idea of culture bound syndromes however the most commonly recognised ojrd are listed in the dsm iv

Question 18

Penis panic

Answer 18

In some cultures that thhink that their penis will retract into their bodies and women may think the same about their breasts this is known as the genetics retraction syndrome. Synch panic hsvf been founded around the world but mainly in Africa and Asia. The origin of the idea may be related to witchcraft

Question 19

Kuru

Answer 19

Is an incurable brain disease found in papau new guinea. The symptons are headeache, shaking and aching limbs death caN occur in the worst cases within about 18 months it is related and is only found in one area in papau new guinea and nearby tribes where there is internarruage. It might be related to funeral pratice of eating the brain. Kuru isn’t a mental disorder but it’s symptons are similar to mental disorder

Question 20

Strengths

Answer 20

The dsm iv tr takes account of cultural issues in acknowledging culture bound syndromes. For example taking account of culture should improve the validity of diagnosis
. There has been an attempt to remove focus from bizarre symptons in schizophrenia as it was acknowledged that such symptons are open to interpretation and that there are cultural issues in interpretations

Question 21

Weaknesses

Answer 21

. Other feature of symptoms of schizophrenia that are listed in the dsm could lead to cultural bias. First rank symptons should perhaps receive less emphasis and abstrebgtg is that this has been suggested weakness is that a clinancian may not follow this suggestion
. Negative symptons oh schizophrenia are more objectively measure and this should be given greater attention where’s in focus is on positive symptons
. There might be some cultural differences in the symptons of schizophrenia such as grandiosity and auditory hallucinations so these shoot be considered seostetly rather as elements of range of symptons