CULTURE AND MENTAL

HEALTH
  Patterns of behavioral or psychological
Mental symptoms that impact multiple areas of life.
These disorders create distress for the person
disorder experiencing these symptoms.
  A combination of psychiatric and
Culture-bound somatic symptoms that are considered to
syndrome, be a recognizable disease only within a
culture-specific specific society or culture.
syndrome 
  Cultures sanction idioms of distress
(alternatives in the expression of psychosocial
distress), define normality and deviance, create
The effect of
illnesses and dictate pathways into care.
culture on
psychopathology  Tseng classified the effects of culture on
psychopathology into six categories:
  Patho-genic effects: Cultural beliefs inducing stress/anxiety
Patho-genic leading to development of disorder. Direct causative effect,
resulting from culturally demanded performance, anxiety,
effects: prescribed roles, duties
  A condition found in the cultures of the Indian
subcontinent in which male patients report that
they suffer from premature ejaculation or
impotence and believe they are passing semen
EXAMPLE in their urine. The condition has no known
organic ethology. In traditional Hindu
spirituality, semen is descried as a ‘vital fluid’.
The discharge of semen is there for associated
with marked feelings of anxiety and dysphoria.
  Patho-selective effects: Through enculturation and
socialization some individual members of a given society
Patho-selective select culturally influenced reaction patterns, which may
effects: be pathological.
  Family suicide as Japanese reactions to stress.
 Malaysian amok men that get humiliated in
EXAMPLE public are expected to take a weapon and kill
everybody that comes their way.
  Patho-plastic effects: Culture modifies the manifestation
Patho-plastic of symptoms. (For example it determines the content of
delusion in schizophrenia.) Only Christian
effects: schizophrenics think they are Jesus.
  Patho-elaborating effects: Behavioural reaction (normal or
Patho- pathological) become exaggerated through reinforcement due
to cultural beliefs of what is normal deviant or special.
elaborating Homosexuality has been seen as psychopathology in the West

effects: until recently. For a long time epilepsy was associated with the
supernatural and considered to be holy.
  Patho-facilitation: Culture influences the
Patho- frequency at which a disorder occurs. Bulimia
facilitation: is more prevalent in Western societies.
  Patho-reactive: The way society and individuals react to
psychopathology affects its course and outcome. (For
example Social stigma vs. acceptance causing a social
anxiety disorder.)
 People with schizophrenia fare better in less-developed
societies because:
Patho-reactive - They tend to have a more fatalistic attitude and
less of a primary sense of control, so they are less
blameworthy towards the schizophrenic.
- Hallucinations and beliefs in possession by
spirits are more common. o They are more integrated in the
society, there is a stronger sense of community.
 Schizophrenia
Existential Universal (emerges across
Universal cultures with relatively stable prevalence
syndromes rates & symptoms) with cultural variance
in modes of expression.
  Delusions
 Hallucinations
 Disordered thinking

Symptoms:  Disorganized speech

 Disorganized or catatonic behaviour
 Lack of insight
 Flattened affect
  Genetic factors
 Prenatal conditions
Causes:  Environmental factors may or may not trigger
one’s disposition
  Auditory/visual/tactile (=relating to the sense of touch)
Amount, kind  Grandiose delusion (= a subtype of delusion characterized by
& content of fantastical beliefs that one is famous, omnipotent, wealthy or

delusions otherwise very powerful.)

 Symptoms may include:
 Problems with thinking and expressing ideas clearly o
Childlike behaviour
 Showing little emotion
Disorganized  Disinhibited agitated and purposeless behaviour It is a more
severe schizophrenia type because the patient cannot perform
daily activities, such as preparing meals and taking care of
personal hygiene
 Symptoms may include:
 Anxious, angry or argumentative
- Paranoid behaviour
 False beliefs that others are trying to
harm you or your loved ones -
  A state of psychogenic motor immobility and
behavioural abnormality manifested by stupor.)
Symptoms may include:
 Lack of activity or hyperactivity
 Erratic movements
Catatonic  Rigid muscles and posture
 Repetitive, cramp-like grimaces or other odd expressions
on the face
 Not responding much to other people
  Existential universal, with cultural variance in
prevalence rates & modes of expression.
 Depression is a common mental disorder
affecting more than 300 million people of all
ages globally. It is the leading cause of
Depression disability worldwide and a major contributor to
the overall global burden of disease. More
women are affected by it than men and at its
worst it can lead to suicide.
 There are effective treatments for depression.
  Sad mood
 Lack of energy/interest
 Emotional changes (guilt, anger, anxiety)
 Physical changes (sleep, appetite, weight)
 Behavioural changes (crying, withdrawal,
Symptoms: agitation)
 Changing self-evaluation (pessimism,
hopelessness, worthlessness)
 Poor concentration/indecisiveness - Suicidal
tendencies
  Neurotransmitter imbalance (serotonin,
norepinephrine and dopamine)

Causes:  Hormonal deficiencies

 Stress
 Certain life events
  Prevalence: 1-year prevalence rates of
1% in China to 10,3% in the USA.
 Understanding: There is cultural
Cultural variation in the meaning of ‘being
differences in depressed’ in terms of language emotion
depression: terms.
 Expression: Somatization vs.
Psychologization:.
  A disorder called ‘Shenjing Shuairuo’ (=Nerve weakness,
=Neurasthenia) in China (used to be so common in the USA
that it was called the ‘America disease’) with symptoms like
bodily weakness, fatigue, headaches, dizziness etc. Some
psychiatrists say this supposed epidemic in China was an
attempt to disguise high rates of mental illness. They said it
‘Shenjing was necessary in an environment where sadness, despair and
fatigue could be interpreted as a lack of dedication to the
Shuairuo’ communist revolution. The diagnose protected people from
some mental illness’ most painful social consequences. Around
the year 2000 it began disappearing. Allegedly due to economic
reforms improving the quality of life, increased freedom to
discuss psychological an emotional problems and the global
influence of Western psychiatry.?
 Emotional expression
 Social stigma of mental illness and social costs
How can we explain of expression
cultural variation in  Differential display rules Emotional experience
modes of expression Moderation of emotions
of depression
 Salience of own emotional states
 - Implicit theory of mind and body-relationship
  Functional Universal with cultural variance in
prevalence rates.
Symptoms:
 Fear of acting inapt resulting in social rejection
 feeling anxious in social situations
Social Anxiety  feeling self-conscious around other people

Disorder  increased heartbeat, sweating, dizziness, and trembling

 blushing or stammering when speaking
 upset stomach — diarrhea or feeling sick
 replaying social situations repeatedly in your mind after they
have occurred

prevalence: 0,7% in East-Asia, 7% in the USA.

 Taijin Kyoufushkou (TKS)
 Culture-bound symptom
Symptoms:
 Preoccupation with (imaginary) physical symptoms (blushing,
Taijin foul odour, deformed body)

Kyoufushkou  Phobia of confronting or bothering others

TKS vs Social Anxiety disorder:
(TKS)  Preoccupation of making other uncomfortable vs. self -
Classification by specific body part vs. social situation
 High prevalence among men vs. women
 High prevalence only in Japan (lifetime prevalence 3-13%