Culture in DSM and ICD Flashcards
Culture in DSM and ICD
Culture and cultural sensitivity and ethnocentric
Culture is the collective beliefs and attitudes and social norms, of a people of a specific area for example a religion or behaviors shared and passed down from Generation to generation
Ethnocentric is when a studies results cannot be applied to different cultures due to cultural differences
therefore a lack of cultural representation in the sample
Cultural sensitivity is the awareness and appreciation of the values norms and beliefs characteristic of a culture with is what not ones own
acompanyed by a willingness to adapt ones behavior accordingly
This is important in diagnosis as different cultures may exhibit or explain certain symptoms in different ways, therefore it is important to be aware of these cultures and their differences to accurately diagnose disorders
Culture in DSM and ICD
DSM V and culture
The DSM V has made different efforts to be culturally sensitive in the creation of its classification system
• It does alert mental health practitioners to not make a diagnosis of mental health without considering the cultural variables, potentially affecting the assessment and diagnosis of such disorders
• The DSM provides guidelines for assessing information about cultural features and individuals mental health problems
• and how these features relate to a social and cultural, context and history
This includes three main aims
• To include culture-related diagnostic issues across most disorders in the dsm v
• To include cultural information to create framework for assessing information about cultural features of individuals mental health problems
• And cultural formulation interviews which are used to obtain information during mental health assessments about the impact of Culture on key aspects of the individual’s clinical presentation and care
Culture in DSM and ICD
ICD 10 and culture
The icd-10 does not mention the need to regard cultural variables when diagnosing people with mental disorders
it however does include a section and cultures specific disorders (as does the DSM)
but it says it is less needed in recent years so it is said to be less relevant in diagnosis
Culture in DSM and ICD
DSM and ICD overview
Both systems consider socio-economic and psychosocial circumstances that may affect diagnosis
but only the DSM-5 considers cultural variables before diagnosis
It aims to combat issues related with cultural diagnosis, framework for assessing cultural features via cultural formulation, in a cultural formulation interview to assess the impact of Culture on key aspects of individuals clinical presentation and care
Where has both include a section on cultural specific disorders however the ICD claims that it is less needed in diagnosis in recent years
Overall the DSM V is more culturally sensitive as it makes practitioners aware of the need to consider cultural variables affects on symptoms for accurate diagnosis and assessment
Culture in DSM and ICD
Scientific model
(Culture doesnt affect diagnosis)
The scientific model claims that culture does not affect diagnosis
• DSM is Made in the USA and is used in other cultures
• though this model is a valid if mental health disorders are defined with specific features and symptoms
for example depression is the same worldwide
• therefore culture would not affect diagnosis as they would use a scientific model to diagnose mental health disorders scientifically in a scientific way
Culture in DSM and ICD
Scientific model support
Lee 2006
Lee 2006
Conducted A Study in South Korea to see if the DSM IV TR was valid in non-western cultures for diagnosis
and it was for ADHD
meaning that culture may not affect diagnosis at all as South Korea has a completely different culture to the Western world
and by the valid diagnosis from the DSM-IV-TR suggests that culture did not play a factor in it
meaning Lee 2006 is evidence to support the Scientific model
Culture in DSM and ICD
Spiritual model
Culture does affect diagnosis
The spiritual model suggests that culture does affect diagnosis
some studies show culture could affect diagnosis
and the DSM is a diagnostic tool for Western cultures, and therefore is useful for diagnosing things in western cultures
however it does note certain aspects of other cultures
meaning that it suggests that it could be adapted to other cultures making it valid in multiple cultures
so yay
Culture in DSM and ICD
evidence for Spiritual model
Evrard 2014 (☆SZ)
Evrard 2014
The study States that’s hearing voices in western cultures signifies schizophrenic symptoms
whereas in other cultures it may be perceived as this person’s being possessed by spirits and therefore looked within a positive and celebrative light unlike in western cultures
• therefore cultural blindness may be an issue as some cultures may jump to conclusions on mental health without Consulting possible cultural variations and attitudes to certain symptoms
Therefore meaning that Evrard 2014 supports the spiritual model of diagnosis
Culture in DSM and ICD
Cultural differences in SZ diagnosis
• ideas that are deemed delusional in one culture are seen as normal in another for example whichcraft
• in some cultures visual off auditory hallucinations and delusions with religious content such as listening to God’s voice are deemed as part of the religious experience and not as a symptom of schizophrenia
• assessment of disorganized speech may be difficult by linguistic variation in narrative Styles across cultures
and it may be just how someone speaks normally
therefore meaning that a false diagnosis may be made
• assessment of affect requires sensitivity this is two differences in Styles emotional expression, eye contact, body language etc as it may vary across cultures
meaning for each culture the assessment of SZ should be adapted to not Deem normal behaviour for them to be seen as SZ symptoms to the Clinician
Culture in DSM and ICD
Study supports SZ cultural differences
Myers 2010
Myers 2010
Found that in the case of studying using the recovery model, that efforts to empower citizens (treatments)
increased stress if they would diagnosed with schizophrenia if their lives were already stressed
This means that cultural differences in for example work patterns can lead to different reactions to treatment
so treatments for schizophrenia should be individualized to each culture and not standardized
so Myers 2010 supports Cultural factors/diff affecting SZ diagnosis and treatment
by suggesting this
Culture in DSM and ICD
Studdy supporting cultural differences/factors effecting the diagnosis/treatment of SZ
Luhrmen et al (2015)
Luhrmen Et Al (2015)
Found that in the USA hearing voices is considered negative
whereas an India and Ghana it is seen as positive
therefore experiences of mental disorders are different across Cultures
And if a patient’s culture is different to the clinicians culture then what they say about the disorder to the clinician may affect the diagnosis
as what the patient says and is normal in their culture
maybe seen to The clinician as symptoms of schizophrenia
and then resulting in a false diagnosis
therefore challenging the validity of diagnosis itself (as its affected by Culture)
Meaning that overall Luhrmen Et Al 2015 supports the idea that culture affects the diagnosis of SZ
Culture in DSM and ICD
Support for culture affecting SZ diagnosis
Kulhara et al 2009
Kulhara Et Al 2009
Found that when reviewing various studies that a developing country
there are more people likely to have a good outcome/outlook of schizophrenia than bad outcomes (opposite of Developed cultures)
This is deemed as favorable outcome hypothesis in developing countries
but also said that Culture shouldn’t be used to explain variants in outcomes but other factors should be explored in research
Kulhara et al’s research supports Cultural effect if SZ diagnosis but they do not
Culture in DSM and ICD
Cultural differences in the definition of learning disorders may be difficult to diagnose
Cultural differences in the definitions of learning disorders may be difficult to diagnose because of the different views on it
as some cultures may see it as shameful or deny it
while others were more likely to aid people with learning disorders
different definitions mean that one coaches may find someone has a learning disorder from certain symptoms while another will Deny it
Culture in DSM and ICD
Cultural differences make the diagnosis of alcohol related disorders difficult
Cultural differences make her diagnosis of alcohol-related disorders difficult because some cultures are more stressed due to isolation and discrimination
so they may take more alcohol and have a higher intolerance to it
therefore it may be difficult to diagnose them with substance abuse as that culture may use on average a lot more alcohol than the clinicians culture
therefore meaning that the clinician is more likely to diagnose them with Alcohol abuse when the amount they are consuming is normal for the culture
Showing Cultural difficultys in its diagnosis
Culture in DSM and ICD
Culture does affect diagnosis
Rastafarian’s use of Neologisms (New Words) ☆
Rastafarian’s use of neologisms (which a new words and plays on English words for example down press into the oppressed etc) is an example of how culture could affect diagnosis
• if a clinician was unaware of this they may see these new words as disorganized thinking
• which is a symptom of schizophrenia maybe leading to a type 1 error or a false diagnosis
• therefore showing how culture can affect diagnosis and it may lead to a misdiagnosis
