1. CULTURE AND PSYCHOPATHOLOGY PSYC 338

2. Culture and Psychopathology What’s normal and abnormal ? Expression of Abnormal Behavior Assessment and Diagnosis of Abnormal Behavior Explanations of Psychopathology Treatment

3. Culture and Psychopathology What’s normal and abnormal ?

4. Roots of inquiry into Culture and Psychopathology Kraepelin (1904) found, on his world tour promoting his system of diagnosis that some cultures may need further examination in diagnosis of their disorders (e.g. latah).

5. Culture permeates all aspects of Psychopathology Experience Expression Explanation Assessment Treatment

6. Explanations of Psychopathology Biological Psychological Social Ecological Spiritual

7. Case Studies A Pakistani patient complains of pain and weakness “ I have pains in my head, I have a body ache” “ I have lost all of my strength” What’s your diagnosis?

8. Expression of Abnormal Behavior Symptoms of depression as an affective disorder Affect- depressed mood Behavior- withdrawn Cognitive- guilt, worthlessness Somatic complaints Is depression manifest the same way across cultures ?

9. Feelings of Guilt Guilt-based societies: “I have done something wrong, and even if it is never discovered and nobody else but me knows about it, I am distressed and disgusted with myself.” Shame-based societies: “I have done something wrong in the eyes of other people. People who matter to me are disgusted with my behaviour, and therefore I am distressed because I cannot face them.

10. What’s normal? Mental illness in a Laotian village Dangerous behavior Disruptive and dysfunctional activities Communication problems Delusions Inappropriate affect Somatic symptoms

11. Culture Specific Idioms of Disease Nervios Ataque de nervios Rootwork Susto

12. Culture Specific Idioms of Disease Nervios emotional distress, headaches, irritability, stomach disturbances, sleep disturbances, nervousness, easy tearfulness, inability to concentrate, tingling sensations, and dizziness

13. Culture Specific Idioms of Disease Ataque de nervios uncontrollable shouting, attacks of crying, trembling, heat in the chest rising to the head, and verbal or physical aggression

14. Culture Specific Idioms of Disease Rootwork illness as the result of hexing, witchcraft, voodoo, or the influence of an evil person

15. Culture Specific Idioms of Disease Susto illness attributed to a frightening event that causes the soul to leave the body, leading to symptoms of unhappiness and sickness

16. Culture Bound Syndromes Latah Amok Koro Anorexia nervosa

17. Culture Bound Syndromes Latah hypersensitivity to sudden fright, often with echopraxia, echolalia, command obedience, and dissociative or trancelike behavior

18. Culture Bound Syndromes Amok dissociative episode characterized by a period of brooding followed by an outburst of violent, aggressive, or homicidal behavior directed at people and objects

19. Culture Bound Syndromes Koro sudden and intense anxiety that the penis (or in the rare female cases, the vulva and nipples) will recede into the body and possibly cause death

20. Culture Bound Syndromes Anorexia nervosa severe restriction of food intake, associated with morbid fear of obesity

22. “Dissociative disorders”

23. Kleinman writes: ‘trance and possession states are ubiquitous in non-western societies and were so in the West prior to the modern age... Only the modern secular west seems to have blocked individuals’ access to these otherwise pan-human dimensions of self’ (1988, p.50).

24. Trance and possession Zar (East Africa) Spell (Southern US) Izizwe (Zulu, South Africa) Speaking in toungues (Fundamentalist Christain US) Kitsune possession (Japan)

25. Trance and possession Kitsune possession (Japan)