Culture plays a vast role in psychology. Psychology being a soft science, the perceptions are subjective across cultures and, therefore, so do the treatments of abnormal disorders. However, abnormality is also subjective in that cultural beliefs define what is normal and what is not.
In the Western world, psychologists use the DSM-IV as a guideline to determine what abnormality is. However, the DSM-IV is not valid in other parts of the world and, as such do not include disorders that are localized in non-Western areas. The ICD-10, however, does include a section on "Other specified neurotic disorders" that include some frequent CBSs, or Culture-Bound Syndromes, including the Dhat syndrome of Indian-Hindu cultures, Koro of the Chinese culture, and Latah.
To analyze the treatments used in the West and the East and compare them, it is necessary to determine the cultural definitions of abnormality.
Cultural Definitions of AbnormalityEdit
Culture Bound SyndromesEdit
Gross (1995) stated that there are universal norms for disorders across cultures, but that the symptoms vary in ways that make them culturally exclusive. The symptoms vary in three ways:
- the form of the symptoms
- the reason for onset
- the prognosis of recovery
Still, there are some disorders that are exclusive to a particular area or section. These are Culture-Bound Syndromes. In order for a disorder to be considered culturally bound, the pattern of symptoms must,
- not belong to classifications for universal disorders as outlined by the DSM-IV and the ICD-10
- occur exclusively in specific geographic areas or populations, and
- have a name in that area or population.
Neither the DSM-IV nor the ICD-10 contain extensive diagnostic criteria for such syndromes, which allude to the cultural-bias that is prevalent in cultural treatment. Pfieffer (1982) concluded that CBSs did exist by stating that such syndromes did not fit into accepted diagnostic criteria and to force fit them would lead to dicounting or ignoring of other, important symptoms. Furthermore, the triggers of the symptoms may not exist in other areas of the world and, therefore, are only available in a certain area. Lastly, the disorder may only be seen as a disorder in a specific area due to cultural beliefs and may not be viewed as abnormal in other areas.
However, Yap (1974) and Berry (1992) disagree that CBSs exist. These researchers suggest that symptoms only differ slightly from symptoms listed in diagnostic manuals and exist in other cultures rather than just the specific one being studied. Finally, they argue that the same general mechanism is the cause of the syndrome and is therefore no different than any disorder listed in the DSM-IV or ICD-10.
Examples of CBSs include:
Treatment in Non-Western CulturesEdit
Biological factors are not considered to be the cause of abnormality differences across culture because the basic brain structure of humans is the same worldwide. Therefore, it is believed that cultural stimuli are more influential in determining prevalence, types of symptoms, and prognosis.
Learning is believed to be the most prevalent reason for abnormal differences across culture. Societies differ in culture and enviornment, and therefore those factors are seen to be the major differences between two specific cultures.
For instance, expression of symptoms varies across cultures due to differences in technology. In the United States and the United Kingdom, for example, schizophrenics believed that messages were being sent to them through radios, satellites, or microwaves. In remote countries with large spiritual backgrounds, like Nigeria, the belief is that someone cast an evil spell upon the sufferer. In such areas, schizophrenics are more prone to act in a paranoid fashion and show more acute signs of paranoid schizophrenia. Therefore, treatment must center around such feelings or beliefs, perhaps by using religious or spiritual beliefs to do so. However, remote areas are better for schizophrenics, as the community of people is much stronger and provides the type of support system that they need.
Stress also plays a role, but because stressors are different, the treatment depends on eradicating different types of stress, especially by religious or spiritual meditation that would not be seen in Western cultures.
Diagnostic differences can be most attributed to the "medicalization" of Western treatments versus the "spiritualization" of non-Western ones. Considerably, in Western society - as opposed to non-Western - the idea that sufferers can be treated and helped allows for diagnosis and treatment. However, in non-Western areas, the sufferer is seen as an abomination; one that is unwell in the physical and spiritual sense.