Intercultural diversity & psychopathology

Question 1

What is abnormality? (4)

Answer 1

Statistical deviance (on tests)
Impairment (depression prevents doing x) 
Subjective distress (anxiety prevents doing x)
Social deviance (controversial e.g. short skirt)

Question 2

The revised outline for Cultural Formulation (DSM V) calls for systematic assessment of five categories:

Answer 2

› Cultural identity of the individual
› Cultural conceptualisations of distress
› Psychosocial stressors and cultural features of vulnerability and resilience
› Cultural features of the relationship between the individual and the clinician
› Overall cultural assessment

Question 3

How should the level of severity and meaning of distressing experiences be assessed?

Answer 3

In relation to the norms of the individual’s cultural reference groups.

Question 4

How do other cultures/ languages convey

psychological distress?

Answer 4

› Latino/Mediterranean: “nerves” headaches = depression
› Asian: weakness, tiredness, “imbalance” = depression
› Middle Eastern: Problems of the heart = depression
› Indigenous Australian: general unwellness rather than specific symptoms = depression
› Yoruba of Nigeria: “an expanded head and goose flesh” = schizophrenia

Question 5

The Native American populations tend to score higher on several of the MMPI-2 scales compared to MMPI-2 norms. What does this mean?

Answer 5

Less likely to indicate a true difference in
pathology levels and more likely to indicate differences in worldview, beliefs and behaviours.
OR as a reasonable response to an oppressive lifestyle (paranoia = real)

Question 6

What is an example of how clinicians see the world through cultural lenses?

Answer 6

Chinese American and European American therapists judged clients differently:

› Chinese therapist viewed Chinese client as adaptable, honest and friendly but American client as aggressive and rebellious

› Euro therapist viewed Euro client as sincere & easy-going but the Chinese client as awkward, confused and nervous

…. also another study showed a different diagnoses (of schizophrenia & personality disorder) for same clients

Question 7

What is etiology?

Answer 7

is the study of causation

Question 8

What model do Western psychologists tend to base psychological understandings upon?

Answer 8

Bio-psycho-social model

Question 9

What are some important cultural considerations/links when assessing minority cultures for psychopathology?

Answer 9

Effects and links to: 
› Migration
› Colonisation
› Marginalisation
› Discrimination: added stress 
› Spirituality

… some cultures are more exposed to negative experiences

Question 10

Children are 8 times more likely to develop what disease if they have grown up in poverty?

Answer 10

Schizophrenia

Question 11

What is the culturally bound syndrome of Amok?

Answer 11

‘Mad with uncontrollable rage’: sudden rage and aggression caused by stress, lack of sleep, loss, drug abuse

Question 12

What is the culturally bound syndrome of Hwabyeong?

Answer 12

“Anger illness” / “fire illness”: neurotic symptoms

Question 13

How does Anorexia Nervosa differ across cultural groups?

Answer 13

China: extreme distaste for food
Western: Fear of getting fat

Question 14

The South African shaman would differentiate between two states…

Answer 14

Spirit possession that needs healing

Spirit possession that needs training (e.g. they have a gift)

Question 15

What are the imitations of the current therapeutic approach to treating psychopathology?

Answer 15

Very individualistic - can cause uncomfortableness
Therapist presents own world view
Goals of therapy vary cross-culturally

Question 16

What are some barriers to seeking treatment?

Answer 16

Language
Stigma: shame or loss-of-face
Mistrust: white institutions
Social structures: expensive / geography

Question 17

What are some differences of Indigenous healing apposed to Western healing?

Answer 17

› Less separation of mind and body
› Stronger emphasis on religion/spirituality to
understand the problem
› Less use of biomedical knowledge
› Heavy reliance on family and community
networks

Question 18

When assessing a patient you will need to look at 4 things:

Answer 18

 Predisposing factors (vulnerabilities)
 Precipitating factors (triggers)
 Perpetuating factors (what maintains the problem)
 Protective factors (strengths)