Chapter 9 Flashcards
(26 cards)
What is Abnormal behavior? (4)
Out of the norm
Statistically rare
Personal Distress
Dangerous
Culture affects psych disorders in 5 areas
- Subjective experience is culture-based including knowledge about psych problems
- Idioms of distress is culture based explanation and expression of symptoms according to culture based display rules
- Diagnoseses- is culture based on various disorders including professional and non judgements
- Treatement is culture based way ppl attempt to overcome symptoms
- Outcome is culture based principles according to which the restults of treatment are evaluated
Relativist Perspective
- is
- focuses on
- ex
on psychophatology is view that humans develop ideas, norms, and learn emotional responses according to cultural prescriptions. Therefore ppl of diff cultures understand psych disorders diff and diffs are signif. What may be considered psychopathological in one culture can be normal in another; Depends on the culture
- Interpretation of peripheral symptoms
Defenders of relativist view target ethnocentrism and most salient type promted by cult majorities
− Ex: spirit possession common and natural in Africa and South America but in West diagnosed as schizo
Universalist Perspective
- is
- focuses on
- examples (7)
is view that suggests existences of absolute, invariable symptoms of psychopathology across cultures. States that despite cultural differences, ppl share similar features including attitudes, values, behavioral responses, so overall understanding of disroders is universal
- Focus on central symptoms
−States cultural impact imp but not overstated; psychopath phenomena across cultures is universal in origin and expression
−Ex: Alzheimers, dementia, parkinson’s, schizo, mental retardation, autism bipolar
Central symptoms
- are
- ex in MDD
can be observed in practically all world populations
− Ex: central symptoms for MDD seen as c-cultarrly caused by biochem factors, include fatigue, lack of concentration, anhedonia
Peripheral symptoms
- are
- ex of MDD
are cultural specific
− Ex: peripheral symtptoms of MDD in Canadians may feel guilty
Cultural-Bound Syndromes
set of psych phenonmena; recurrent, locality specific patterns of aberrant behavior, troubling experience that may not be linked to DSM category. They don’t have correspondence with disorder recognized by mainstream systems
C-B syndromes 7 categories
- An apparent set of psych symptoms not attributale to identifable organic cause which is recognized as an illness in partic group but not in illness category of West
- An apparent set of psych syptoms which resembles a Western category but which 1) has locally salient features diff from west 2)lacks some symtpoms reconized in West
- A discrete disease entity not recognized by western professionals
indigenous to cannibalistic tribes in New Guinea - An illness they symptoms of which occur in many cultural settings however it is only elaborated as an illness in one or few settings
- Culturally accepted explanatory mechansism or idoms of illness which do not match western idioms and in a western setting might indicate culturally inapporpriate thinknig and perhaps halluncinations
- Set of behaviors often including trance or possession state; hearing, seeing, and communicating with spirtis or feeling lost form soul. Could indicate psychosis, delusions, hallucninations in western setting
- A syndrome occuring in c setting which does not in fact exist but may be reported to professional
Examples:
- Amok
- Shenjinshaijo
- Kuru
- Koro
- Rootwork
- Windigo
- Amok is sudden explosion of anger in Malaysia
- shenjinshaijo or neuroasthenia in China resembles MDD but more somatic features and lacks depressed mood found in west
- Kuru is a progressive psychosis and dementia from protein problem; indigenous to cannibalistic tribes in New Guinea
- Koro is fear of genetials retracting
- Rootwork (in carribean) or the Evil eye
- windigo (indians) a sydrome of cannibal obsessions
Acculturation
degree to which a member of a culturally diverse group accepts an adheres to the values, attitudes, and behaviors of the majority group
4 types of acculturation
Integration – incorporates many aspects of dominant culture, but maintains culture as well
Assimilation – accepts majority culture and relinquishes their own
Separation – withdraws from majority culture and accepts their own
Marginalization – does not identify with majority or minority culture
Therapist-client matching:
important because? (2)
- however?
- premature termination (4 ethnicities)
- Increased duration of therapy
- Decrease in premature termination
- However it has no impact on therapy outcome except for Hispanics
Hispanic equal to Caucasian > Asian > African-American
Therapist-client matching depends on (5)
Ethnic identity Level of acculturation Gender Trust of whites Similarity in values
Cultural competence determined by (3) depends on (2)
Awareness – therapist is aware of their own assumptions, values and beliefs that may influence them
Knowledge – therapist attempts to understand the world views of culturally diverse clients (e.g., history of oppression)
Skills – therapist uses interventions that are appropriate for culturally diverse groups
- Credibility –clients’ perception that therapist is an expert
- Giving – clients’ perception that he or she has received something from the therapist (e.g., skill)
APA guidelines for c-c psychotherapy (6)
- No language barriers
- Identify level of acculturation
- Be sure not to evaluate culturally relevant behavior as pathology
- Recognize that discrimination and prejudice are real problems for members of diverse groups in the U.S.
- Acknowledges cultural differences and encourage client to talk about them
- Don’t over-generalize cultural patterns to all members of that group
African American Clients:
- world view (3)
- may exhibit?
- treatment approach?
Interconnectedness of all things – group welfare
Family – extended kinship network (nuclear and extended)
Egalitarian relationship between genders
- May exhibit signs of cultural paranoia
- Include multiple systems (church, family, etc.) in treatment
American-Indian/Alaskian clients:
- world view
- 3
- treatment approach? (2)
- Spiritual/holistic harmony with nature
Illness is due to disharmony
Strong sense of cooperation
Prefer listening to talking
Approach:
Value-free – consider history and work on establishing credibility
Collaborative, incorporate elders, family, community
Incorporate their own traditions
American-Indian/Alaskian clients:
- world view (2)
- illness due to?
- strong sense of?
- prefer?
- treatment approach (3)
- Spiritual/holistic, harmony with nature
- Illness is due to disharmony
- Strong sense of cooperation
- Prefer listening to talking
- Value-free – consider history and work on establishing credibility
- Collaborative, incorporate elders, family, community
- Incorporate their own traditions
Asian clients:
- world view
- value (4)
- have?
- treatment approach (3)
- Depends on country of origin; Hierarchical family structure
- Value harmony, interdependence, loyalty & obligation
- Restraint of strong emotions
- Direct, structured, goal-oriented approaches
- Focus on meaningful change – alleviating symptoms
- Present as knowledge expert/authority figure
Hispanic/Latino clients:
- world view (2)
- value
- unacceptable
- treatment approach (4)
Prefer family welfare over individual welfare; Concrete, tangible approach to life – attributions to God
- Value interdependence, connectedness, & sharing
- Unacceptable to discuss personal problems with stranger
- Active, direct, multimodal (affect, cognitive, biology)
- Emphasis on somatic complaints
- Patriarchial family systems
- Non-flexible sex roles
Anxiety disorders
- central symptoms
- peripheral symptoms (ex)
− Central symtpoms include persistent worry, fear, constant state of apprhehension distrupting daily function
− Peripheral signs of GAD can vary; in most western anxiety related to way ppl view their success
Depressive Disorders
- central symptoms
- 3 examples of peripheral symptoms (lats,china,m-east)
- 3 factors that influence clinical pic of mood disorders around the world
- most interesting c-c finding
- dysphoria, anxiety, tension, lack of energy, and ideas of insufficincy
1. headaches in latino’s and mediterranean countries
2. weakness, imbalance, and tiredness in chinese
3. problems of heart in middle easterners
1) diagnostic practices 2) understanding of symptoms by individual 3) disclosure of symptoms
- diff in dispalying somatic vs psych symtpms of affective illness; some somaticize while others psychologize their distress (westerners use more psych and non use more somatitization)
Schizophrenia
- cultural diffs (3)
- gender diffs
High admission rate in Ireland; US blacks have higher rates than whites; acute and catatonic cases more prev in developing countries compared with developed nations
- most countries its men more than women except for china
Tolerance threshold
stands for a measure of tolerance toward specific personality traits in culture. Low threshold stand for relative societal intolerance against specific behaviors and personality traits and high stands for tolderance
If society accpets diversity of behaviors then tolerance thresh is high
