Lecture 9: Physical and Mental Health

Question 1

SES and health outcomes [10]

Answer 1

• British civil servants study; how can we explain this?
• More money means more access to good medical care?
  
  • But Britain has universal healthcare, so this should be equal
• Lower SES people in jobs that are more hazardous?
  
  • But even in the same job → still showed SES health pattern
• Lower SES → cultural contexts more encouraging of unhealthy habits?
  
  • But even when different levels of unhealthy behaviours are controlled for, there’s still a clear relationship
• Best explanation: lower SES people experience greater stress
  
  • They’re more vigilant to threat b/c they’re experiencing more threats on a day-to-day basis
  • → b/c of a lack of control over what they’re doing (lower in status hierarchy, being told what to do)

Question 2

acute stress [3]

Answer 2

• Short term stress most people experience every day
• Necessary + adaptive for us to survive
• Not related to negative health outcomes, it’s about how you recover

Question 3

chronic stress [1]

Answer 3

• Stress that is constant and persists over time + related to negative health outcomes

Question 4

objective vs. subjective SES [2]

Answer 4

• relative deprivation: Knowing that others around you are doing better than you + perceiving deficiency in relation to these people
• More egalitarian societies = lower relation between health and social class

Question 5

Curhan et al. (a) [9]

(hint: relative deprivation + health)

Answer 5

• Differences in objective vs. subjective perceptions of wealth + impacts on wellbeing in USA vs. Japan
• Hypothesis: individualist cultures → subjective feelings more important b/c your self-focussed perceptions are more important
  
  • Collectivist cultures → objective feelings more important b/c that’s what people can see
• Objective social status: education attainment level
• Subjective social status: community ladder → “At the bottom are the people who have the lowest standing in their community. Where would you place yourself on this ladder?”
• Well-being: 8 scales of well-being
• Results: subjective perceptions are more important for both cultures
  
  • But subjective more important for USA
  • And objective still more important to Japanese

Question 6

negative affect [3]

Answer 6

• Differences in the way negative affect is viewed across cultures
• Western cultures: negative emotions construed as internal entities and are the individuals responsibility
• Eastern cultures: negative emotions construed as situational and grounded in specific relationships

Question 7

Curhan et al. (b) [7]

(hint: negative affect + wellbeing)

Answer 7

• How does negative affect affect wellbeing in USA vs. Japan?
• How often they had experienced negative emotions over the previous 30 days
• Physical health: number of chronic conditions, degree of functional limitations, and subjective global health
• Mental health: psychological well-being, self-esteem, and life satisfaction
• Negative affect (+)corr. w/ chronic conditions + physical functioning for both cultures
  
  • Negatively correlated w/ global health + all mental health measures
• Correlations were stronger for USA participants + significantly stronger for chronic conditions, physical functioning, psychological wellbeing, self-esteem

Question 8

Kitayama et al. (2010) [15]

(hint: culturally-sanctioned goals)

Answer 8

• How important is achieving culturally-sanctioned goals for your wellbeing?
• Goals stem from culturally prevalent ideas and practices
  
  • Western cultures emphasize importance of personal control
  • Eastern cultures emphasize importance of relational harmony
• Measured: independence (e.g. personal mastery) + interdependence (e.g. relational harmony with family members)
  
  • Chronic constraint: “cannot do what I want to do”
  • Well-being and health
• Japanese Ps experienced more perceived restraint overall, perhaps b/c living in collectivist society prevents you from achieving your goals (insofar as they’re self-focussed)
  
  • Higher personal control → lower perceived constraint
• Personal control (+)corr. w/ wellbeing for both
  
  • More significant predictor among Americans vs. Japanese
  • Control + sense of self as efficacious → central to independence that’s emphasized + privileged in NA
• Relational harmony also (+)corr. w/ wellbeing for both
  
  • But relation much stronger for Japanese Ps
  • Responsiveness to others + attendant social harmony → valued in Japan

Question 9

mental health + culture [7]

Answer 9

• Our environment plays an important role in the development of mental health issues

Culture determines:

• types of physical and social stressors
• types of coping mechanisms and resources to mediate stressors
• basic personality patterns (self-structure, motivation systems)
• language systems that organize perceptions + responses to reality → mental health treatments
• standards of normalcy, deviance, health
• classification patterns for various diseases and disorders

Question 10

biopsychosocial model [1]

Answer 10

Question 11

Dr. Jessica Dere on culture + mental health (TEDxUTSC) [1]

Answer 11

• Need to consider cultural factors when defining mental illness, since they’re patterns of behaviour that deviate from cultural norms

Question 12

eating disorders [4]

Answer 12

• anorexia nervosa: (Western societies) Refusing to maintain a normal body weight, be intensely fearful of gaining weight/becoming fat, deny the seriousness of one’s low body weight
• bulimia nervosa: Recurrent episodes of binge eating + induced vomiting, inappropriate behaviours to prevent weight gain
• As images of thinner women being more attractive increase
• In other parts of the world; more Western exposure → higher rates

Question 13

hikikomori​ [2]

Answer 13

• (Japan) Social withdraw, affected people may appear unhappy, start to lose friends, become insecure and shy
• Not being afraid to go outside, just need to get away from society

Question 14

amok [4]

Answer 14

• (Malaysia + Southeast Asia) An acute outburst of unrestrained violence, associated w/ (indiscriminate) homicidal attacks, preceded by a period of brooding + ending with exhaustion+amnesia
• Particularly among males, caused by stress, lack of sleep, alcohol
• Maybe related to passive cultures where people don’t have an outlet for their frustrations + tensions
• Maybe seen in Western countries; killings tend to be more premeditated → questionable if it’s the same psychological disorder underlying it

Question 15

kufungisisa [1]

Answer 15

• (Zimbabwe) anxiety + somatic problems stemming from mental exhaustion

Question 16

depression [4]

Answer 16

• Not all depressed individuals show the same symptoms
• somatization: Experiencing symptoms primarily in bodies (Eastern)
  
  • Correlated with extent of individual’s held collectivist beliefs and beliefs that these are normative, not perceptions of stigma
• psychologization: Experiencing symptoms primarily in minds (Western)

Question 17

social anxiety disorder [2]

Answer 17

• Fear that one’s in danger of acting in an inept/unacceptable manner → disastrous social consequences
• East Asians more likely to report symptoms of social anxiety disorders, but less likely to be diagnosed w/ them

Question 18

taijin kyoufushou (TKS) [2]

Answer 18

• Phobia of confronting others; similar to SAD, but along with physical symptoms (e.g. extensive blushing, heightened body odor, sweating, a penetrating gaze)
• Not only preoccupied with these symptoms but also a certainty that these symptoms will offend + create unease in others

Question 19

schizophrenia [4]

Answer 19

• Delusions, hallucinations, disorganized speech, grossly disorganized/catatonic behaviour, negative symptoms
• Even with obviously biologically-based condition, there are still striking cultural differences in the experience, course, + outcome:
  
  • Paranoid schizophrenia more prevalent in UK
  • Catatonic schizophrenia more prevalent in India

Question 20

Western mental health treatment [1]

Answer 20

• Psychotherapy treatments are often used in West, but may not be as useful in societies less likely to verbally disclose to strangers + acknowledging mental health is stigmatized

Question 21

social support [3]

Answer 21

• Receiving sufficient social support plays key role in coping w/ psychological distress + various physical health benefits both within + across cultures
• indigenous psychotherapies: Emphasize relationship between client, therapist, + society
• morita therapy: Goal isn’t to change client’s symptoms, but to change their perspective on the symptoms

Question 22

cultural competence [4]

Answer 22

• Recommends that therapists should:
• 1) Recognize their own cultural influences so they can consciously deal with their own defenses, interpretations, projections
• 2) Develop knowledge about cultural background of their client
• 3) Develop appropriate skills to intervene in therapy sessions in a way that’s culturally sensitive + relevant