Social science Flashcards
How is medical anthropology associated to global mental health?
- It is associated with the emergence of GMH
- It is the subject of the critics of GMH
What does medical anthropology examine?
The social and cultural construction of health and illness
- consider how perceptions of the body and self shape the experience of illness
- used to investigate eastern medical practices
- now investigates western medical practices
Who was Evans-Pritchard?
20th century anthropologist
What is the book of Evans-Pritchard ‘Witchcraft oracles, and Magic among the Azande’ (1937)?
> First modernist work of anthropology - influential
> Empiricist tradition
> In-depth ethnographic exploration of witchcraft in the explanation of illness and misfortune
- Azande witchcraft “is not an objective reality” vs. scientific understandings
How did Evans-Pritchard’s empiricism reflect on clinical encounters around the world?
> Doctors saw empirical evidence as needed for the patients’ complaints to be considered meaningful
> Doctor-patient differences in models and understandings of illness and treatments can be problematic
- inhibiting resolution of health
What did the psychiatrist Roland Littlewood (1999) in the context of anthropology and psychiatry?
He recognised clinical training of psychiatrists was missing information on culture and experience
- vital to understanding the patient’s problems
What did the work of Roland Littlewood (1999) reflect?
A move from pure biological approach to one grounded in history, culture and interpretation
What did the new approach to medical anthropology consist of?
Interactions between philosophy, anthropology and social science
-> more cautious, self-reflective and critical approach
-> anthropology to understand how cultures formulate reality in different distinctive ways
What did the new approach to medical anthropology at the end of the 20th century acknowledge?
- Undermined claims that biomedicine is an arbiter between knowledge and belief
- Ethnographers are no longer seen as impartial
- Culture is no longer understood as mentalistic, voluntary and individualist
- Individualism does not match this new understanding
What is the role of culture in global mental health?
Role of culture in shaping experience must be taken into account in the design and implementation of research and services
Which two approaches polarised cross-cultural psychiatry?
- Emic approach
- Etic approach
What does the Emic approach consist of?
Evaluates phenomena from within the culture to understand its significance in local context
-> more difficult to compare across different cultural settings
What does the Etic approach consist of?
Presumes psychiatric categories, instruments and models designed in the west are universally acceptable
-> experiences outside of narrow categories may be excluded
What does the integrated approach of global mental health consist of?
Places value on both
- local beliefs about illness and its categorisation
- AND the western biomedical model
Who were the pioneers of the integrated approach of global mental health?
What did they develop?
Vikram Patel and Arthur Kleinman
- > Exploratory model approach
- to assess illness experience
What is the common ground most global mental health researchers set themselves in?
Between the Universalist approach and the Relativist approach
- many mental disorders have core symptoms which are shared across cultures (expression varies)
- cultural variation is an important force
- > ethnographic methods are essential to understanding the experience of mental illness
- crucial for meeting global aims
How is universality reflected in depression?
Shared core symptoms
-> depression must be universal
How is cultural specificity reflected in depression?
- Different rates are observed in different cultures
- Personal and social implications of depression vary across cultures
- Recognition by clinicians vary across the world
- > Expressions of distress are culture-bound syndromes
What does the hierarchy of evidence imply?
- Science is cumulative, builds on evidence
- Only considers quantitative evidence
- Important questions (how, why) can only be addressed by qualitative methods
What does epidemiology emerge from?
Positivism:
- objective reality that we can reduce to a set of empirical indicators
- uncover a single truth
- investigator and investigated are separate
What does anthropology emerge from?
Constructivism:
- reality = social construct
- multiple realities that change
- qualitative: relationship research-subject will shape the findings and explicitly explore the phenomenon
- > focus on social processes and meanings
What is the benefit of multi-disciplinary research?
Can help to provide a full picture of health and illness?
Why is it important to select the right research question?
What your inquiring determines the methodology