LEC 8 - Culture, Globalization and Mental Illness

Question 1

Many criticize the models of mental illness

Answer 1

they fail to include culture in their list of variables

Question 2

A person’s symptoms are partially shaped by their behaviour and experiences

Answer 2

Culture is not related to ethnicityWe are made up of a number of overlapping cultures

Question 3

DSM criteria

Answer 3

-Very limited cultural background of those who make the DSM
- American, white, upper-middle class
- DSM might reflect this specific cultural viewpoint

Question 4

Possession vs psychosis (Latin)

Answer 4

Spiritual possession, becomes a religious problem and treatment is religious intervention rather than psychopharmaceuticals

Question 5

Culture and Experience

Answer 5

Defines if a behaviour is considered deviant
- Hallucinations in First Nations communities vs. non-indigenous communities
- Seen as a blessing if you hear voices of ancestors

Question 6

Expression of illnesses, done in a culturally accepted way

Answer 6

Act crazy in a way that is culturally appropriate, makes sense to those around us
- Depression in west vs. east Asia—those suffering from depression exhibited different expression of symptoms based on culture

Question 7

Likelihood of developing disorders

Answer 7

Some theorize less chance of antisocial and narcissistic personality disorder in “collectivist” cultures
- Social/communal harmony is more important than an individual realizing their own potential

Question 8

Culture and Care

Answer 8

The way that we receive care/treatment depends on cultural context

Question 9

Culture Bound Symptoms

Answer 9

Own section of the DSM: type of mental illness that is only found/recognized by a specific culture group
- Localized, folk, diagnostic categories that frame coherent meanings for certain repetitive, patterned, and troubling sets of experiences and observation

Question 10

Amok

Answer 10

dissociative episode featuring a period of brooding followed by outburst of aggressive behaviour aimed at people and objects
- person becomes exhausted and collapses; remember nothing upon waking up and return to normal
- loss of social status, in men

Question 11

Dhat

Answer 11

Person experiencing it has these fears that in some way their penis is shrinking and will stop working/fall off; losing their essence through their body
- Vague somatic symptoms of fatigue, weakness, anxiety, loss of appetite, guilt, and sexual dysfunction attributed to loss of semen in nocturnal emissions through urine and masturbation

Question 12

Pibloktoq (Arctic Hysteria)

Answer 12

Follows the loss or perceived loss of a valued person or object
- Feel like they have been harmed in some way
Too much vitamin A in the diet? Eating too much meat
- A response to colonialism?

Question 13

Fibromyalgia

Answer 13

Chronic pain disorder, unknown source
- Increase in the last 20 years
- Not diagnosed as a mental illness

Question 14

Many illnesses are largely confined to the West

Answer 14

ADHD, Depression, PMDD

Question 15

Problems with Culture bond

Answer 15

• Ethnocentricity (is it really just non-western?)
• Are there just different diagnosing patterns?
• Are we exoticizing other cultures?

Question 16

Cross-Cultural Psychiatry

Answer 16

Brings together the recognition of culture and the universality of mental disorders
- Theorists have debated the extent to which psychiatry can truly be considered cross-cultural and universal
- Some assume cross-cultural portability of psychiatric theory and practice (depression, but it is expressed differently)

Question 17

Psychiatry and Globalization

Answer 17

Envolves the flow of ideas, goods, money, and people in a global context
- Efforts to develop international nosologies (classification system); DSM produced by AMERICAN Psychiatric Association
- World Health Organization; still very Americanized

Question 18

International Trauma Intervention

Answer 18

Go in to make sure these places are not traumatized by setting up psychosocial programs
- The same place you might go to get a care package or food, you can also receive psychosocial counselling
- Working through experiences given moral value, may be other ways of dealing with problems
- Only talks about problems
- Revealing personal information to the workers/volunteers might not be culturally appropriate

Question 19

Expansion of Western Model I

Answer 19

Despite little history of depression, western physicians and pharmaceutical marketers descended en masse to Japan in 1990s, seeking new market for SSRIs
- To find a market, they had to stimulate a demand
- Started teaching about depression and offered training sessions to Japanese psychiatrists

Question 20

Expansion of Western Model II

Answer 20

In Hong Kong, anorexia had a particular expression of symptoms prior to late 1990s which focused on somatic complaints (stomach pain) rather than fat phobia
- Once media got a hold of the DSM-4, it began to explore anorexia in Western terms
- Within a half a decade, 90% of patients were complaining primarily of fearing weight gain and the old culture-bound expression disappeared