Lecture 7- Social and Cultural Approaches Flashcards
What does culture play a role in?
Determining what is and is not abnormal
What do decisions on abnormal behaviour involve?
Social judgments based on values and expectations of one’s culture
What is the DSM definition of delusion?
A false belief based on incorrect inference about the external reality. Not accepted by other members of the people’s culture of subculture.
What does Williams say about socially adaptive belief?
Human belief formation is sensitive to social rewards and punishment. Beliefs are formed due to unconscious expectations due to agents (those who reward us when we hold ungrounded beliefs and punish us when we hold reasonable ones)
What are beliefs?
Group markers that will identify us with that group
What were the views of homosexuality in the DSM?
DSM I and II considered homosexuality a form of mental disorder
Who looked at homosexuality treatment by behaviour modification?
Pradhan et al
What did Pradhan et al do?
Treatment of 13 homosexuals with behaviour modification. Did classical electrical aversion and positive conditioning
What did Pradhan et al find?
Change in sexual orientation lasting on 6 month 1 year follow up. Presence of homosexual partner and passive anal intercourse indicated a poor response
What occured in the late 60s with beliefs of homosexuality?
Gay/lesbian rights leaders challenged assumption that homosexuality was pathological
What occurred in 1973 with homosexuality?
APA board of trustees agreed to remove homosexuality as a form of mental illness
What were the Freudian views of homosexuality?
Emotionally smothering mothers and detached hostile fathers play a causal role.
What did Rado, 1962, say about the Freudian view of homosexuality?
Homosexuality occurs when heterosexual desires are psychologically threatening.
What does the DSM IV say about gender identity?
Gender identity disorder is intense discomfort with one’s biological gender and strong identification with the opposite gender
What does the DSM V say about gender dysphoria?
Emphasises the importance of distress about incongruity about biology and identity
What is the role of sociocultural factors in mental disorders?
Symptoms and patterns are cross cultural and they predict prevalence
Who looked at sociocultural factors in mental disorders?
Andrade et al
What did Andrade et al find?
Assessed the prevalence of major depressive disorder and found the prevalence ranged from 3% to 17% in the USA
What are pathogenic social influences?
Low socio-economic status, unemployment, prejudice, discrimination, social media, violence and homelessness
What was found in the Western society with low SES and unemployment?
Correlation with mental disorder and stronger for certain types of disorders such as APD in the lower 3 income band than depression
What is unemployment associated with?
Emotional distress and vulnerability to psychopathology
What did Piotrowska et al?
Poor families suffer more stress and then model more dysfunctional parenting and antisocial behaviour
How can mental disorders lead to low SES?
Suffering from primary and secondary difficulties
How can race and gender effect mental health?
Schizophrenia being a high diagnosis for AA men due to their symptoms and their connection to the civil rights movement
Who looked at how social media link to mental disorder
Vannucci et al
What did Vannucci et al find?
Social media use leads to increases in anxiety in adults
How does social media link to mental disorder?
Social media users are more aware of stressful events experienced by online friends.
Social media can be used to isolate and cause social comparisons
How does violence effect mental health?
Domestic violence against women and children leads to PTSD, depression, anxiety
How does homelessness relate to mental health?
1/3 of homeless people are effected by severe mental illness
What is the goal of the DSM?
Identify and diagnose mental health problems in a similar way across cultures
What is somatisation?
The tendency to experience and communicate emotional distress in the form of physical symptoms
Is somatisation common in western culture?
No and they report less somatic symptoms when reporting psychological distress
Why is somatisation common in Asian cultures?
As they disapprove of strong expression of negative emotions
What are the methodologies challenges for depression in the Native American Elder?
No word for “depressed” in certain Native American languages.
Prevalence investigations need to adapt tests and measures across linguistic and cultural barriers.
Care must be taken not to miss culture-specific elements and manifestations.
What is culture and behaviour in Western Culture?
More tolerant
What is culture and behaviour in Eastern Culture?
High intolerant of undercontrolled behaviour such as disobedience and aggression and taught to inhibit expression of anger
What is the expression of anger associated with?
The biological health risk but moderated by culture
What did Kitayama et al find with anger?
Greater impression of anger predicted increased BHR for Americans but reduced BHR for Japanese
What did MacAndrew say about culture and drunkenness?
If you are in a group of people and see them drinking you assume you can drink the same amount meaning if you go out and drink you assume you can drink the same amount
What did Tan et al say about culture?
Report cases of systematised delusions involving the internet as cultural factors can shape the content of reality distortion symptoms
Who looked at Capgras delusions and culture?
Ellis and Young
What did Ellis + Young say about Capgras delusions?
They result from damage to neural pathways underpinning the emotional component of face recognition
What is the link between Capgras delusion and culture?
The same neurocognitive impairment may manifest in different contents influenced by culture
What are the most common delusional themes?
Paranoia, grandiosity and the ideas of reference
Who did the Truman Show Delusion?
Gold and Gold
What did Gold and Gold do?
Found 5 patients who believed they were subject similar to a reality TV show and broadcasting their daily life
What were the findings from Gold and Gold?
Patient 1 believed that 9/11 was fabricated
What can culture shape in disorders?
The expression of psychopathology where symptoms could be more or less unique to a particular culture
What are examples of culture specific disorders?
Chowdhury et al= puppy pregnancy
Wendigos= fears centres on turning into cannibals by a power of a monster with a craving for human flesh in Native American culture
Hikikomori- disorder of social withdrawal where young people stay in their bedrooms and refuse social interaction for at least 6 months
Who looked at religion?
Stavrova
What does religion serve as according to Stavrova?
A protective factor for health due to association with coping mechanisms, social support and health behaviours
What does religion influence according to Stavrova?
Individuals to perceive themselves as healthier and independent of their physical health status
What are the positive aspects of religion?
Individuals live longer compared to non-religious
Countries with strong norm of religion report more positive and less negative emotions
They have a low propensity for health related damaging behaviours
Who looked at the gender differences in depression?
Piccinelli and Wilkinson
What are the gender differences between men and women in depression?
Women have higher rated of depression than men
Depression is early onset in women than men
What gendered symptoms do men and women have?
Women have more internalised symptoms such as guilt but men have externalised symptoms such as substance abuse
What are risk factors for depression?
Gender roles, societal expectations, discrimination, violence and socio-economic status
What effect does biological factors have on depression according to Piccinelli and Wilkinson?
Hormonal fluctuations, genetic predispositions show little to no effect to gender differences
Who looked at women and difficulties in depression?
Frank et al
What did Frank et al find?
Women have more difficulties with appetite, sleep and somatic anxiety
Who looked at the course of depression in women?
Kessler et al
What did Kessler et al find?
Women have longer durations of depressive episodes
Who looked at cultural aspects in social anxiety?
Hofmann
What are the key points from Hofmann?
Social anxiety and SAD manifest differently in different cultures
Collectivist cultures are about grouo harmony and conformity so social anxiety may be expressed
Individualistic is about personal achievement and independence so social anxiety is due to failure and rejection
Some cultures stigmatise mental illness so there is reluctance to seek help
Therapeutic approaches should consider cultural beliefs and values
