Culture

Question 1

24y/o Colombian-American is concerned about how to maintain his parent’s cultural heritage after he marries a Caucasian. Which type of acculturative stress is he dealing with? (4x)

Answer 1

INTEGRATION

Question 2

47 y/o F w/ increased preoccupation with questioning her lifelong affiliation with her church and has been spending time visiting other churches. Concerned she is losing her faith, feels guilty and anxious. No SI, MSE normal, states would never act against her moral beliefs. Dx? (3x)

Answer 2

RELIGIOUS OR SPIRITUAL PROBLEM

Question 3

14 y/o Native American Indian girl brought to mental health center b/c she has visions of spirits. Tells psychiatrist spirits are elders who appear, give her advice. No hx substance abuse/mental disorder. Interview w parents reveals they are traditional & feel daughter’s visions are a gift. But they are worried about schoolwork, which has deteriorated b/c she has been preoccupied with spirits. Tx should focus on: (3x)

Answer 3

DEALING WITH HER SCHOOL PROBLEMS

Question 4

How is ethnicity defined? (2x)

Answer 4

GROUP OF INDIVIDUALS SHARING SENSE OF COMMON IDENTITY, COMMON ANCESTRY, SHARED BELIEFS, & HX

Question 5

20 y/o western trained psychiatrist of northern European descent has been asked to treat a 40 y/o Hindu patient who emigrated to the US 2 years ago. The patient presents with complaints of weakness, fatigue, headaches, insomnia, palpitations, and decreased appetite. The patient also reports a 5 lb weight loss over the last month, dysphoric mood with intermittent anxiety, and suicidal ideation. In addition to assessing the patient’s level of suicidality, it would be appropriate for the psychiatrist to do which of the following when beginning treatment? (2x)

Answer 5

ASK THE PATIENT WHAT HE BELIEVES EXPLAINS THE SYMPTOMS

Question 6

Racial/ethnic group with highest rate of suicide? (x2)

Answer 6

NATIVE AMERICANS

Question 7

Social psychological study of the view of self in some western cultures has delineated differences from the definition of self in many non-western cultures. What best describes the basis for positive self-esteem in those non-western cultures? (2x)

Answer 7

POSITIVE CONTRIBUTIONS TO THE GROUP AND HARMONIOUS RELATIONS

Question 8

Acculturation outcome associated with high risk for suicide, substance abuse, and alcoholism (x2):

Answer 8

LACKING STRONG ALLEGIANCE TO NATIVE CULTURE, AND NOT INCORPORATING HOST CULTURE

Question 9

Puerto Rican and other Latin American pts are more likely than those from western culture to report their depression as what? (x2)

Answer 9

NERVOUSNESS

Question 10

Appropriate response to immigrant patient with vague complaint

Answer 10

HOW WOULD YOU DESCRIBE YOUR PROBLEM TO A FAMILY MEMBER OR FRIEND?

Question 11

What most accurately describes scientific understanding of the concept of race?

Answer 11

SOCIOPOLITICAL DESIGNATION ASSIGNING INDIVIDUALS TO A PARTICULAR GROUP THAT HAS MEANING DERIVED FROM PREVAILING SOCIETAL ATTITUDES

Question 12

How is “race” different than “ethnicity”?

Answer 12

RACE IS BASED ON PHYSICAL CHARACTERISTICS WHEREAS ETHNICITY INCORPORATES MULTIPLE FACTORS

Question 13

American psychiatrists over dx in African American patients w mood/psychotic sx?

Answer 13

SCHIZOPHRENIA

Question 14

Which of the following is a component of the psychiatrist’s formal cultural formulation of a pt’s disorder:

Answer 14

THE PT’S EXPLANATION OF THE ILLNESS

Question 15

Culture-bound syndrome in Caribbean and states bordering Gulf of Mexico - anxiety, GI distress, weakness, fear of being poisoned, attributed to witchcraft

Answer 15

ROOTWORK

Question 16

Which is the most significant disadvantage of using a family member as interpreter for a patient who does not speak the psychiatrist’s language?

Answer 16

PT MAY CENSOR COMMENTS TO KEEP INFO FROM THE FAMILY

Question 17

Most common complaint in southeast Asians who are dx w/ mental disorder is:

Answer 17

MULTIPLE SOMATIC SYMPTOMS

Question 18

Culture bound in industrialized countries per DSM IV

Answer 18

BULIMIA

Question 19

What culture-bound syndromes would be Dx for a pt with of insomnia, HAs, anorexia, fears, despair, diarrhea, & anger?

Answer 19

ATAQUE DE NERVIOS

Question 20

Which demographics indicate both a common ancestry and a shared sense of identity, belief and history?

Answer 20

ETHNICITY (NOT RELIGION)

Question 21

Family response to a member with ataque de nervios would most likely be to do what?

Answer 21

RALLY TO SUPPORT RELATIVE BY REMOVING STRESSORS

Question 22

Treating 40 year old Hindu patient who presents with weakness, fatigue, headaches, insomnia, palpitations, decreased appetite. 5 lb weight loss over last month, dysphoric mood with intermittent anxiety, suicidal ideation. What else to assess besides suicidality?

Answer 22

ASK PATIENT WHAT THEY BELIEVE IS CAUSING SYMPTOMS

Question 23

Females of which ethnicity report highest rates of intimate partner violence?

Answer 23

NATIVE AMERICAN

Question 24

Research shows dissociative symptoms most commonly represent what worldwide?

Answer 24

NORMAL PART OF RELIGIOUS/RITUAL EVENT

Question 25

What DSM-IV diagnosis is likely for 41 y/o man with increasing sense of conflict about changing his beliefs from work-oriented to faith-oriented. No past or present psych symptoms, stable vocational hx.

Answer 25

RELIGIOUS AND SPIRITUAL PROBLEM

Question 26

48 y/o with chronic sadness and no relationships since husband died 12 years ago. Normal grieving, no DSM-IV criteria for d/o, has successful career and close friends. States has conversations with her dead husband and he talks to her. Believes in heaven. Likely classification of these experiences is:

Answer 26

PART OF A BELIEF SYSTEM ENDORSED BY HER RELIGION

Question 27

According to the World Health Organization, what is the number one psychiatric cause of loss of years of healthy life as measured by disability-adjusted life years for individuals between ages of 15 and 40 years?

Answer 27

UNIPOLAR MAJOR DEPRESSION

Question 28

Whenever the culture of western med has been a focus of inquiry by anthropologists, what diagnosis has been seen as a culture bound syndrome in north America?

Answer 28

DISSOCIATIVE IDENTITY D/O

Question 29

Pt’s family believes depression is 2/2 santeria curse. During assessment, psych should focus on…

Answer 29

LEARNING FROM PT AND FAMILY WHAT THEY BELIEVE THE COURSE OF THIS ILLNESS IS EXPECTED TO BE

Question 30

Immigrants to US experience stress & demoralization most during which period?

Answer 30

DURING FIRST 1-3 YEARS IN THE COUNTRY

Question 31

22 yo M pt complains of fatigue, abd pain, weight loss and believes it is caused by nocturnal emissions of semen. What is pt’s ethnic background?

Answer 31

SOUTHEAST ASIAN

Question 32

Common ancestry + a shared sense of identity, beliefs, and history

Answer 32

ETHNICITY

Question 33

An accurate statement regarding assessment for cultural ID:

Answer 33

INFLUENCED BY ONE’S DEGREE OF ACCULTURATION

Question 34

30 y/o MD who has emigrated from China to the US continues to take pride in family recipes, but has recently embraced American ballroom dancing. This represents which of the following:

Answer 34

ACCULTURATION

Question 35

The culturally and Linguistically Appropriate Services (CLAS) federal standards for healthcare organizations require the organizations to:

Answer 35

HAVE PT-RELATED MATERIALS AVAILABLE IN THE PT’S NATIVE LANGUAGES.

Question 36

A Japanese family who recently moved from Japan brings their 6 yo child for an evaluation. They express concerns that the child appears depressed, is reluctant to go to school, and is fearful that harm will befall the parents. During the evaluation it is noted that the child sleeps in the same room as the parents. Which of the following is the most likely explanation of this sleeping arrangement?

Answer 36

CULTURAL NORM

Question 37

Psychiatrist evaluates recent immigrant with complaint of altered nerves” Clinical interpreter from pt’s cultural background explains that culturally the nervous system is believed to be altered by stressful life events. What cultural group does pt most likely belong to?

Answer 37

HISPANIC AMERICAN