Week 3: Acculturation & Mental health (BOOK: Chapter 7 & 14)

Question 1

Explain acculturation

Answer 1

= the process of cultural change when one interacts with another culture; second culture learning; it is different from the process of first-culture learning (enculturation)
–> People’s acculturation experiences vary dramatically (reason of migration, kind of environment, personalities, goals), so it is a challenging subject to study. Extracting a set of generalizable findings or any cumulative theories is difficult.

Question 2

Explain two kinds of culture

Answer 2

Heritage culture = someone’s original culture
Host culture = the new culture someone needs to learn

Question 3

What are 6 examples of adjustments when moving to a new culture

Answer 3

• psychological adjustment
• acquiring a new language
• learning new interpersonal and social behaviors
• getting used to new values
• becoming part of a minority group
• adjusting one’s self-concept

Question 4

Explain what a migrant is and 2 sub-definitions

Answer 4

Migrant = person that moves from their heritage culture to a host culture (the new culture)
- Sojourner = a migrant that intends to stay in the host culture temporarily
- Immigrant = a migrant that intends to stay in the host culture permanently

Question 5

Explain the acculturation curve and its 3 stages

Answer 5

= an adjustment pattern found to be shared among many immigrants, although with varying timing

1. Honeymoon stage: initial phase of positive feelings about the host culture
2. Crisis stage: phase of culture shock in which
   there are anxious, helpless, irritable, and generally disoriented and homesick feelings on moving to the host culture; also known as culture shock
3. Adjustment stage: a gradual phase of adjustment and more positive feelings to the host culture.

–> For sojourners, reverse culture shock can also happen upon returning to their home country.

Question 6

What is one societal feature of the host culture that can help the adjustment of newcomers

Answer 6

Ease with which migrants can be accommodated

Question 7

Compare adjustment to host cultures in homogenous compared to heterogenous cultures

Answer 7

The acculturation curve (over 5 years) for people migrating to Japan compared to the US mostly lacked the adjustment phase and looked more like an L. It is possible that in homogenous societies, the adjustment stage takes longer, and that of the people had been researched for longer that they would’ve found evidence for the adjustment phase. Nonetheless, the succes of people’s acculturation experiences seems to be influenced by the homogeneity of the society in which they are trying to acculturate.

Question 8

What are 3 factors influencing people’s acculturation experiences and how easily they adjust

Answer 8

1. Cultural distance = the difference between two cultures (the heritage and host culture) in their overall ways of life. Acculturation is easier when the cultural distance is smaller. Those who grow up speaking language similar to English (Germanic languages) perform better on English language tests than those speaking more distant languages (Romance languages).
2. Cultural fit = the degree to which an individual’s personality is compatible with the dominant cultural values of the host culture. The greater this fit, the more easily acculturation is. People with an independent self- concept acculturate more easily to individualistic than to collectivistic cultures.
3. Acculturation strategies = The success of anyone’s acculturation experiences depends on one’s attitudes toward the host culture (effort to participate) and toward the heritage culture (effort to maintain traditions), which lead to distinct acculturation strategies.

Question 9

What are 4 acculturation strategies and compare them

Answer 9

1. Integration strategy = Involves efforts to fit in and fully participate in the host culture, while at the same time striving to maintain the traditions of the heritage culture. People using this strategy have positive views toward both their heritage and their host cultures—they are seeking the best of both worlds.
2. Marginalization strategy = Involves little or no effort to participate in the host culture or to maintain the traditions of the heritage culture. People using this strategy have negative views toward both their heritage and their host cultures. This strategy is relatively rare and is theoreti­cally puzzling.
3. Seperation strategy = Involves efforts to maintain the traditions of the heritage culture, while making little or no effort to participate in the host culture. This strategy is composed of posi­tive attitudes toward the heritage culture and negative attitudes toward the host culture. This is the approach of people who do not want to acculturate to the host culture. They would prefer to continue to exist in the cultural world of their heritage culture.
4. Assimilation strategy = Involves efforts to fit in and fully participate in the host culture, while making little or no effort to maintain the traditions of the heritage culture. People using this approach have positive attitudes toward the host culture and negative attitudes toward the heritage culture, reflecting a desire to leave behind the ances­tral past in order to fit in with the new culture.

• Integration is the most common and succesful strategy, and marginalization is the least common.

Question 10

What 3 factors influence what strategy an immigrant is likely to use

Answer 10

• A person will not strive to fit into the host culture if that culture shows a good deal of prejudice toward the individual’s own cultural group
• People with physical features that distinguish them from the majority in the host culture will probably face more prejudice than people whose physical features let them blend in
• The extent to which majority members of the host culture value cultural diversity and tolerate cultural differences also predicts the amount of prejudice immigrants experience

Question 11

Explain two kinds of models of cultures

Answer 11

1. Multicultural/Salad bowl model: the distinct qual­ities of immigrant cultures are maintained
2. Assimilationist/Melting pot model: immigrants are encouraged to act like the locals, and both models shape the way immigrants relate to the dominant culture

Question 12

Explain the immigrant paradox

Answer 12

= Refers to a common finding that children of immigrants have a variety of negative outcomes, such as lower educational achievement and poorer physical and mental health, than their parents. This pattern is paradoxical because children of immigrants are more acculturated, or assimilated, than their immigrant parents.

Question 13

Explain 2 different kinds of influence that discrimination can have on someone

Answer 13

While acculturation can be a relatively painless and gradual process of adjustment for some people, other people are not all treated with equal respect. Discrimination and prejudice are a huge problem.

1. Identity denial = When a minority group individual’s identity is called into question because he or she does not seem to match the prototype of the culture. Someone with ancestors from Africa, having a dark skin tone, but born in the Netherlands his/herself might be asked “Where are you really from?”.
2. Stereotype threat = The fear of behaving in a way that will unintentionally confirm a negative stereotype about one’s group.
   –> African American and European American students took a test consisting of verbal items and some were reminded of their race (which activated negative stereotypes for African American’s) by checking a box indicating it (race prime). African Americans did way poorer on the test in the race prime condition than in the condition without a race prime.
   –> Merely the activation of stereotype threat can result in the confirmation of the stereotype.

Question 14

Explain in what 2 ways multicultural people (who have been exposed to multiple cultural worldviews) can organize their experiences

Answer 14

1. Blending = the tendency for bicultural people to show psychological characteristics in between those of their 2 cultures.
2. Frame-switching = alternating between different cultural selves

Question 15

Explain how people would be expected to think from a “blending” perspective

Answer 15

If multicultural people use blending, we would expect them to show responses to psychological measures that are intermediate to responses of monocultural (one culture) people from different cultures. Asian-Americans would be expected to think in some way that lies between the mainstream American or Asian way of thinking.

Question 16

Give 2 examples of evidence for “blending”

Answer 16

• Acculturation: Participants from Japan or Canada had their self-esteem measured after arriving at the other country and after 7 months of staying there. Canadians are associated with having more self-esteem than East Asians. Japanese participants’ self-esteem scores were significantly higher after they had been in Canada for a while than when they had just arrived. The reverse was the case for Canadian’s.
  –> The longer someone is in a culture, the more likely it is that the meta-schemas of thoughts and feelings that are activated are associated with the host-culture.
• Blending: The self-esteem of students in Japan and Canada, with differing degrees of exposure to Canadian culture, was contrasted. Results showed that more exposure of the Japanese to Canada led to higher self-esteem (blending). However, the self-esteem scores of Asian’s only reached Canadians’ scores after they were the 3rd generation to be in Canada.
  –> Multicultural people blend their cultures together to reach a level that is in the middle of the 2.
  –> Complete acculturation takes a long time.

Question 17

Explain how people would be expected to behave from a “frame-switching” perspective

Answer 17

Multicultural people can develop multiple selves, each equipped to deal with a specific cultural environment. The different cultural selves get activated by different contexts. Native Indonesian speakers in an English-speaking country do not speak a blended language but will speak Indonesian in Indonesian contexts and English in English contexts.
Research has shown that people tend to frame-switch when they shift between their languages: language can be a prime for frame-switching.

Question 18

Explain external vs. internal attributions and give an examples of evidence

Answer 18

External vs. internal attributions: Chinese people are more likely to explain people’s behavior in terms of external attributions (situational factors cause people to act a certain way), while Westerners are more likely to explain behavior in terms of internal attributions (personality factors cause people to act a certain way).
- Frame-switching: Westernized Chinese students were shown a picture with 1 fish swimming ahead and had to explain this. Either their Chinese or Western knowledge network was activated by cultural primes. When the Chinese context was primed, the students were more likely to make external attributions as an explanation (the fish is being chased), whereas a Western prime resulted in internal attributions (the fish is leading).
–> People switch their cultural frames based on the context that is activated in their mind.

Question 19

Explain bicultural identity integration (BIC) and give an example of evidence

Answer 19

= The extent to which bicultural people see their 2 cultural identities as compatible or in opposition to each other. Biculturals vary in their degree of bicultural identity integration. The more integration they show, the more frame-switching they usually use.

• Monocultural frame-switching: Biculturals (Asian-Americans) and monoculturals (European-Americans) were compared on their difficulty to be primed. They were primed with either independent or interdependent aspects of themselves and asked to rate the importance of individualistic and collectivistic values. Monoculturals also showed frame- switching, but in biculturals this was more pronounced.
  –> Monoculturals can also be primed to switch between different (cultural) knowledge structures.
  –> Biculturals are more skilled at this because they have more clearly separated information networks.

Question 20

Explain third culture kids (TCKs)

Answer 20

= Also known as global nomads, are people who travel with their expatriate parents and spend large parts of their for­ mative years living in places outside their heritage culture. The so-called first culture of a TCK is the heritage culture of his or her parents, the sec­ond culture is that of the current host country, and the third culture is that of the expatriate community he or she is exposed to in the various host cultures.

Question 21

What is one common frustration of TCKs

Answer 21

The sense of being a minority wherever they go; they have trouble fitting in with non-TCK peer groups. TCKs frequently will say they have more of a global identity than any particular cultural identity.

Question 22

Explain creativity in the context of multiculturalism

Answer 22

Multicultural people appear to be more creative because their multicultural experiences foster integrative complexity. This effect is greater when the different cultures have greater cultural distance and when people feel that their identities are blended.

Question 23

Explain integrative complexity

Answer 23

= a willingness and ability to acknowledge and consider different viewpoints on the same issue

Question 24

Give 2 examples of creativity in multicultural people

Answer 24

1. Adapting and creativity: Participants that had lived in more than one culture were either primed to think about adapting to life in another culture or just observing another culture. Only the group that was primed to think about adapting showed enhanced creativity.
   –> The act of adapting to a new culture leads to more creativity, rather than the personality of people that are likely to move to other cultures.
2. Creativity in real life: It was examined how well multicultural experiences of professional fashion designers predicted the creative innovation ratings of an existing magazine. Their breadth, depth and cultural distance was calculated.
   - Breadth (number of countries): the most creative designers had lived in 2 or 3 different cultures.
   - Depth (number of years abroad): the more years people had lived abroad, the higher the rated creativity.
   - Distance (cultural distance): those who had lived in moderately different cultures were rated as most creative.
   –> The effects of multicultural experiences on creativity are not limited to performance in lab studies.

Question 25

Explain the main topic and main conclusion of the podcast “Is the rest of the world ‘crazy like us’?”

Answer 25

Main topic: American’s are teaching the world how to define and treat mental illnesses, which is disrupting how other cultures heal themselves and might even spread mental illnesses.
Main conclusion: We should look at how we can offer the Western scientific knowledge to the rest of the world without trampling on beliefs that might be very valuable themselves.

Question 26

Explain what was said in the podcast about pharmaceuticals, DSM, cultural narratives and inviting western ideas

Answer 26

Pharmaceuticals:
The major pharmaceuticals have financial gains by the homogenization of what illnesses are across culture. They promote certain diseases (promoting what is considered pathological sadness (depression) in America, while it might not be in Japan), for which their drugs are claimed to be the fix.

DSM:
The standard diagnostic tool in America is the DSM. It is spreading around the world while it can be questioned how much the ideas in the book carry cultural assumptions and how much they can be used in other cultures.
Importing the Western diagnoses (such as the DSM) can lead to the self-shaping of the expression of certain disorders. Back in the early ‘90s Hong Kong, anorexia had nothing to do with fat phobia. Then, after the DSM diagnosis was imported from the West, Hong Kong saw a rise of the diagnosis in the American form: fat phobia.

Cultural narratives:
Sometimes, aspects of cultural beliefs can be helpful for people in certain cultures, even though these stories are not necessarily ‘scientific truths’. In Zanzibar, people with schizophrenia are seen as being possessed by a spirit, which is a belief that ties a person very closely to the group and might therefore be helpful for the person.

Inviting Western ideas:
The spread of the Western ideas of mental illnesses goes both ways. Not only does the West impose their ideas on other parts of the world, these other cultures also often invite them in and desire these ideas. They might think anything from the West has to be better.

Question 27

Explain psychological disorders in differing countries

Answer 27

Psychological disorders do not have the same prevalence in all cultures. Psychological disorders present themselves in a variety of different ways around the world.
Giving a specific definition of what a psychological disorder is, is difficult because certain behaviors are viewed as problematic in one culture but not in another.

Culture-bound syndromes = groups of symptoms that appear to be greatly influenced by cultural factors, and hence occur far less frequently in some cultures than others, or manifest in highly divergent ways across cultures.

Question 28

Explain hikikomori

Answer 28

= A self-incarceration and withdrawal from all social interaction outside family members for at least 6 months, including no participation in school or work.
–> Appears to be unique to Japanese culture

Question 29

Explain Dhat syndrome

Answer 29

= Morbid anxiety around concerns that one is losing semen.
–> Most prevalent in South Asia

Question 30

What are the two most common eating disorders and describe their prevalence (specifically for different cultures/countries)

Answer 30

1. Anorexia nervosa = an eating disorder characterized by a refusal to maintain a normal body weight, an intense fear of gaining weight or becoming fat, and a denial of the seriousness of abnormally low body weight.
2. Bulimia nervosa = an eating disorder characterized by recurring episodes of binge eating along with inappropriate behaviors to prevent weight gain (self-induced vomiting, misuse of laxatives), occurring at least twice a week for 3 months.

Prevalence:
The prevalence rates for eating disorders have increased dramatically over the past 50 years, just as the age at which people develop them has gotten significantly lower.
- Bulimia: seems to be confined to modern cultures with Western influences.
- Anorexia: evidence is mixed because in contrast to bulimia, it is found in diverse cultural contexts with relatively little Western influence and also, people in some cultures (Hong Kong) often lack a fear of fatness (which is a key symptom in the West).
–> They are commonly thought to be culture-bound syndromes

Question 31

Explain Koro

Answer 31

= Morbid anxiety that one’s penis is shrinking into one’s body.
–> largely prevalent in South and East Asia

Question 32

Explain Ataques de Nervios

Answer 32

= Emotionally charged / stressful incidents bring on symptoms such as palpitations, numbness, and a sense of heat rising to the head.
–> common in Puerto Ricans but also observed in other Latino populations

Question 33

Explain Amok

Answer 33

= An acute outburst of indiscriminate violence followed by amnesia and exhaustion.
–> appears to be prevalent in a number of South-East Asian countries

Question 34

Explain hysteria

Answer 34

= Symptoms such as fainting, insomnia, sudden paralysis, temporary blindness, loss of appetite for food or sex, and general disagreeableness.
–> one of the most common syndromes (in women) in mid 19th century Europe

Question 35

Explain Frigophobia

Answer 35

= Morbid fear of catching a cold, which leads people to dress themselves in heavy coats and scarves even in summer.
–> China

Question 36

Explain Susto

Answer 36

= Feelings that a frightening experience has dislodged the soul from one’s body, leading to a wide range of physical and psychological symptoms.
–> Latin America

Question 37

Explain Voodoo death

Answer 37

= Conviction that one has been cursed or has broken a taboo, which results in a severe level of fear that sometimes leads to death.
–> Africa

Question 38

Explain Latah

Answer 38

= A transient dissociated state in which one exhibits unusual behavior (barking like a dog, acting in inappropriate ways) after some kind of startling event.
–> South-East Asian countries and Siberia

Question 39

Explain Malgri

Answer 39

= The belief that one has been invaded by a spirit that makes them sick and drowsy in response to entering the sea or a new territory without engaging in the appropriate ceremonial procedures.
–> Australian Aboriginal groups

Question 40

Explain Agonias

Answer 40

= Anxiety disorder that can include a wide array of symptoms such as a burning sensation, loss of breath, hysterical blindness, and sleeping and eating disorders.
–> Portuguese and Azoreans

Question 41

Explain Kufungisisa

Answer 41

= Anxiety and somatic disorder believed to be caused by excessive thinking.
–> Zimbabwe, but also in other countries in different variants

Question 42

What are 4 universal conditions

Answer 42

• Depression; (1) depressed mood, (2) inability to feel pleasure, (3) change in weight or appetite, (4) sleep problems, (5) psychomotor change, (6) fatigue or loss of energy, (7) feelings of worthlessness or guilt, (8) poor concentration or indecisiveness, and (9) suicidality
  –> one of the most common disorders
• Social Anxiety Disorder; A fear that one is in danger of acting in an inept and unacceptable manner, resulting in negative social consequences (social rejection)
  –> very common
• Schizophenia; At least 2 of the following symptoms: (1) delusions, (2) hallucinations, (3) disorganized speech, (4) disorganized or catatonic behavior, and/or (5) other negative symptoms (flattening mood, loss of speech)
  –> existential universal disorder, but there is variation in the most common subtypes as well as in the course of the illness
• Suicide; Although suicide is recognized across cultures, its frequency varies enormously just as the tendencies (time points in one’s life) and motivations that are involved.

Question 43

Explain the presentation of depression can look in different cultures (2)

Answer 43

Somatization = when symptoms of an illness are primarily experienced physically rather than psychologically.
–> China
Psychologization = when symptoms of an illness are primarily experienced psychologically rather than physically.
–> Westerners

Question 44

What is the difference in MDD prevalence in China compared to the USA

Answer 44

China: 1%
USA: 10.5%

Question 45

What are 2 possible causes of the variation in the presentation of depression

Answer 45

There has been much debate about the cause of cultural difference in presentation of depression:
1. Social stigma: in Chinese contexts there might be greater social costs in acknowledging a psychological disorder than a physical issue compared to Western contexts.
–> Koreans who describe their distress using physical terms receive more empathy than those who use psychological terms.
2. Focus: people from some cultures tend to notice and focus on certain symptoms more than others, and more than people in other cultures.
–> Westerners might pay closer attention to their psychological symptoms (emotional states) because they are somehow more meaningful to them.

Question 46

What is the difference in SAD prevalence in East Asia compared to the USA

Answer 46

0.5% in East Asia vs. 7% in the USA

Question 47

Explain the diagnostic prevalence and presentation of SAD in different cultures/countries

Answer 47

Social anxiety is more prevalent in cultural contexts where there is more emphasis on the value of fitting in with others (collectivism; East Asia), however, people in East Asia are less often diagnosed because it is seen as less of a problem to be concerned about interpersonal relationships there.
When social anxieties do get recognized as problematic, there are different presentations of symptoms across cultures (eg. tajin kyoufushou).

Question 48

Explain tajin kyoufushou

Answer 48

= a culture-bound disorder (highly prevalent only in Japan) involving a preoccupation with physical symptoms (blushing, sweating) associated with social anxiety. The ‘offensive type’ of TKS also includes being concerned that the symptoms will offend and create unease in others.
TKS is different from SAD in that there is a preoccupation with making others uncomfortable (instead of oneself) and in that it is highly prevalent among men (instead of women).
–> similar disorder to SAD but with different presenting symptoms

Question 49

What are 3 possible causes of schizophrenia

Answer 49

• It is well-established that genetic factors affect the likelihood of developing schizophrenia.
• Prenatal conditions and neuroanatomical differences between schizophrenic and healthy individuals play a role.
• Environmental factors are also involved, because people with an identical twin with schizophrenia still have a better than 50% chance of not developing it.

Question 50

What are 3 subtypes of schizophrenia

Answer 50

There is cultural variation in the proportion of the subtypes of schizophrenia:
1. Paranoid schizophrenia: delusional visions; more frequent in the UK.
2. Catatonic schizophrenia: a near absence of motor activity; more frequent in India.
3. Disorganized schizophrenia: incoherent and illogical thoughts and behaviors.

Question 51

Explain the course and prognosis for schizophrenia in different countries/cultures

Answer 51

The course and prognosis for schizophrenia was observed to be better for patients in less-developed (non-industrialized) societies. People in these countries tend to have a more fatalistic attitude and a weaker sense of personal control over their lives, which may lead to more acceptance of people with schizophrenia. Also, hallucinations and beliefs of possession are more common there, so schizophrenic symptoms may not be considered abnormal.

Question 52

Explain differences in frequency rates and motivations for suicide for schizophrenia

Answer 52

Frequency rates:
People in different cultures tend to commit suicide at different points in their lives. Suicide has become more prevalent in traditional cultures that have been Westernized and in colonized indigenous populations.

Motivations for suicide:
In the West, suicide is most often seen as stemming from various mental disorders and other tragic life events. In other cultures, other motivations play a bigger role. In Japan, accepting responsibility and preserving one’s honor is an important motivation to commit suicide.

Question 53

Explain differences in treating mental illness cross-culturally in the context of social support

Answer 53

Receiving adequate emo­tional assistance and encouragement has been shown to play a key role in coping with psychological distress, but people seek and provide social support differently cross-culturally.
–> European Americans are far more likely than East Asians to actively seek help from others
–> North Americans typically give emotion-focused help, while East Asians tend to offer problem-solving support

Question 54

Explain differences in treating mental illness cross-culturally in the context of psychotherapy and other methods
–> 2 models of healing from indigenous cultures
–> 2 methods emerging from Japan

Answer 54

The commonality of Western approaches to mental illness is that the evaluation of people and their conditions hinges on the client’s ability to engage in a psychological discourse that is grounded in shared cultural meanings. Other methods of treating mental disorders have emerged elsewhere.
–> Study with indigenous healing practices (in Africa, Asia, South America and Middle East) identified 2 models of healing; 1) the family who played the most important role in solving problems, and 2) focus on spiritualism and religion.
–> Two methods emerging from Japan;
- Morita = meant for anxiety and depression, about accepting the circumstances of your life as they are; involves periods of isolated bed rest, light manual activities, heavy manual labor, reading of Moritist litera­ture, and life training
- Naikan = helps people gain insight about their past; therapist encourages clients to appreciate how indebted they are to the kindnesses of important close people in their lives

Question 55

Explain differences in treating mental illness cross-culturally in the context of multicultural therapeutic settings (concept of cultural competence)

Answer 55

Therapists who work with clients from cultural backgrounds other than their own should strive to achieve cultural competence = the ability to recognize one’s own cultural influences, have knowledge about the cultural background of one’s clients, apply skills to intervene in therapy sessions in relevant and culturally sensitive ways and to be flexible about when to generalize from the client’s culture to the mainstream culture and when to individualize the client.
Perhaps the current best method for therapists working in multicultural settings is the cultural consultation service. A group of psychologists/psychiatrists, social workers, nurses, etc from various disciplines meet regularly to discuss cases referred to them by therapists. They identi­fy issues relevant to the therapy that lie outside the experience of many therapists (eg. family systems, migration stresses, etc). Also invite interpreters, consultants, etc from other disciplines.