Kirmayer & Ryder (2016). Culture and psychopathology

Question 1

early vs later literature

Answer 1

early: exotic “culture-bound” syndromes
later: eurocentric models and norms

Question 1

mood disorder differences

Answer 1

Mood disorders such as depression and bipolar disorder, exhibit core symptoms that can be identified across cultural contexts, but there are significant variations in modes of expression and response, which may influence:
* coping
* help-seeking
* treatment response

Question 2

anxiety disorder differences:

Answer 2

varies across cultures, with:
* lower prevalence in Asia (except for social anxiety)
* higher in South America.

Question 3

sociale angst in Japan

Answer 3

Taijin Kyofusho (worry about offending others). this is linked to perceptions of low relational mobility (the degree to which individuals in a society have the freedom and opportunity to form new relationships and disengage from existing ones)

Question 4

hikikomori

Answer 4

self-isolation in Japan

Question 5

The literature has often claimed that non-Westerners tend to express mental health issues through physical symptoms (=somatization). However…

Answer 5

this claim involves over-generalizations based on cultural identity (Western versus non-Western, Asian or African), it also lumps together diverse forms of somatic distress, and makes unsystematic comparisons between samples from different settings (mental health clinic versus primary care or community).

Question 6

psychotic disorder differences

Answer 6

Psychotic disorders have been viewed as biologically determined, but there is also evidence for the cultural shaping of symptoms, as well as the onset and course of illness.

Meta-analyses have confirmed a higher incidence of psychosis among certain migrants and minority ethnic groups, particularly Black African and Black Caribbean migrants in the UK. This seems to be linked with the impact of: post-migration and discrimination and neighborhood ethnic density (not due to biological vulnerability).

Question 7

The change from DSM-IV to DSM-5 shows a stronger effort to take into account cultural differences in diagnostic criteria

Answer 7

oke

Question 8

DSM-5 replaces the concept of ‘culture-bound syndromes’ with 3 different types of cultural concepts of distress:

Answer 8

• Cultural syndromes (= clusters of symptoms that may be related to but are not be ‘bound’ or limited to local cultures)
• Causal explanations or attributions (Explanatory models of Illness EM’s) e.g. ‘fright illness’ or ‘susto’
• Cultural idioms of distress (= everyday ways of talking about distress that cut across syndromes e.g. ‘nerves’)

Question 9

what clinical tool is there to enhance diagnostic assessment

Answer 9

Cultural Formation Interview (CFI)

Question 10

4 domains of the CFI

Answer 10

1. Cultural definition of the problem
2. Cultural perceptions of cause, context and support
3. Cultural factors affecting self-coping and past help-seeking
4. Cultural factors affecting current help-seeking