LEC 8 - Culture, Globalization and Mental Illness Flashcards
Many criticize the models of mental illness
they fail to include culture in their list of variables
A person’s symptoms are partially shaped by their behaviour and experiences
Culture is not related to ethnicityWe are made up of a number of overlapping cultures
DSM criteria
-Very limited cultural background of those who make the DSM
- American, white, upper-middle class
- DSM might reflect this specific cultural viewpoint
Possession vs psychosis (Latin)
Spiritual possession, becomes a religious problem and treatment is religious intervention rather than psychopharmaceuticals
Culture and Experience
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
Expression of illnesses, done in a culturally accepted way
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
Likelihood of developing disorders
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
Culture and Care
The way that we receive care/treatment depends on cultural context
Culture Bound Symptoms
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
Amok
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
Dhat
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
Pibloktoq (Arctic Hysteria)
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?
Fibromyalgia
Chronic pain disorder, unknown source
- Increase in the last 20 years
- Not diagnosed as a mental illness
Many illnesses are largely confined to the West
ADHD, Depression, PMDD
Problems with Culture bond
- Ethnocentricity (is it really just non-western?)
- Are there just different diagnosing patterns?
- Are we exoticizing other cultures?
Cross-Cultural Psychiatry
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)
Psychiatry and Globalization
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
International Trauma Intervention
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
Expansion of Western Model I
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
Expansion of Western Model II
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
