Key question Flashcards
What is our key question?
Is it a problem for society if different cultures define mental health disorders differently?
Introduction
It is a problem for society if there are significant variations in how the ICD and DSM classify Schizophrenia and Anorexia Nervosa, affecting the reliability and validity of diagnosis. Additionally, individual differences, like the society the individual is in, can influence how people interpret mental health and their own symptoms.
Paragraph 1- schizophrenia and anorexia diagnosis comparing the DSM-V and ICD-10, how culture affects this
Schizophrenia
DSM-V= one month of active symptoms and 6 months of disturbance to everyday life is a requirement of diagnosis ICD-10= this classification is not required, instead the manual uses subtypes to diagnose.
Anorexia
ICD-10= Example of how energy is restricted
DSM-V= Measures the severity of the disorder, which the ICD-10 does not
Affecting culture evidence
Rastafarian culture use neologisms as a play on english words- a clinician unaware of these conventions may see this as a sign of disordered thinking when interviewing a person with signs of mental distress, rather than a cultural difference.
Conclusion
Therefore, cultural variations are going to affect diagnosis making it difficult to establish appropriate explanations for clinical disorders.
Paragraph 2- Culture does affect the DSM-V (sz)
DSM-V diagnoses through ‘best fit’ with data gathered through interview.
Culture does affect AO1
Ethnocentric, created by the APA, contents are based upon those in Western Cultures.
Evidence
Census as a methodology of diagnosis of Schizophrenia= Phillips et al (2004) sees a prevalence of 5.3 per thousand in China, whereas Lemkau et al sees a prevalence of 2.9 per thousand.
Luhrmann et al found that 70% of Americans said their voices told them to hurt people, whereas 50% of Ghanians said the voices were mainly positive.
Conclusion
Given cultural differences in the patterns of diagnosis society should focus on non-biological explanations for mental health disorders.
Paragraph 2- Culture doesn’t affect the DSM-V (counter)
Culture doesn’t affect AO1
Not as ethnocentric as it appears, addresses cultural differences
Evidence
DSM-5 involves a section addressing cultural concepts of distress which details ways different cultures may describe and talk about symptoms, this assists clinicians in recognising how people in different cultures interpret their disorder.
Conclusion
Shows progress is being made to reduce ethnocentrism
Paragraph 3- Culture doesn’t affect the ICD-10
ICD-10 diagnoses through the selection of key words by a clinician through interviews Each disorder is split into subtypes, ps is F20.0, and F20.1 is Hs.
Culture doesn’t affect AO1
ICD-10 is used cross-culturally, free and accessible and produced in multiple languages, used by many.
Conclusion- Therefore, cultural relativity is less of a problem for the ICD-10.
ICD counter (culture does affect)- Gurland
Gurland demonstrated that psychiatrists in NYC were more likely to diagnose patients with Sz than affective disorders compared to psychiatrists in the UK, shows how indv differences in cultural background and training can affect interpretations of symptoms.
EVAL- it seems that cultural differences in the ICD10 are more prevalent as it is used across different cultures, therefore cultural variance will have worse consequences as it will affect more people than the DSM would.
Gurlands research shows that opposing diagnoses is dangerous for society due to the administration of different drugs. Giving antipsychotics to someone with affective disorder= problematic, worsening symptoms
Para4- Diagnosis in collectivist cultures- china
Collectivist cultures (China) have their own classification manuals. The CCMD is similar in its structure and categorisation to the DSM-V and ICD-10, however includes some variations and around 40 culturally related diagnoses- less of a problem for society overall.
Less of a problem as it only affects people in particular region of China, which suggests if the classification manual, albeit specific, reflects the culture of those it is diagnosing, there will be less diagnosis
Paragraph 5- positives of cultural differences
AO1- The 4D model acknowledges how behaviour is culturally relative within the category of Deviance. For example, talking to spirits is not universal and may be considered odd in our culture.
AO3- Becker et al found that exposure to Western culture brought an interest in dieting that was not present before in Fiji; brought with it the first symptoms of eating disorders into a society that previously had no incidence of anorexia
Conc- this shows acknowledgement of cultural differences within diagnoses and how this can be applied to mental health disorders worldwide.
Conclusion
Overall, Western societies follow the ideas of the DSM or the ICD and often see unusual characteristics as abnormal, therefore a disorder. The CCMD shows more of an awareness of cultural differences, for example through the inclusion of 40 culture related disorders. Ultimately, the awareness of the differences between culture in terms of diagnoses is important, as it is a problem for society if they are defined differently.
