Culture Bound Syndromes

Amok

Violent, disorderly, or homicidal rage accompanied by amnesia, after which the individual may commit suicide

• Also called bouffée délirante (delirious outburst)

• Acute and transient psychotic episode with sudden onset

• Hallmark: Violent outburst → amnesia afterward → sometimes suicide

• Usually preceded by social withdrawal, humiliation, or perceived insult

• Involves sudden, uncontrollable violent rage, attacking people or destroying property without clear provocation

• Origin: Malaysia/Indonesia

• Resembles berserker, mal de pelea, colerina, ataque de nervios, and iich'aa

• Random homicidal violence + amnesia

Bangungot

Sudden unexplained nocturnal death associated with groaning and moaning during a nightmare

• Also known as Sudden Unexplained Nocturnal Death Syndrome (SUNDS) or Oriental Nightmare Death Syndrome

• Individual repeatedly groans and moans during a nightmare

• May lead to death at the climax of the episode

• Cause of death remains unknown

• Seen mostly in healthy young Southeast Asian males

• Origin: Southeast Asia

Brain Fag Syndrome

Cognitive and somatic symptoms attributed to excessive academic pressure

• Cognitive symptoms: reduced concentration and poor memory

• Somatic symptoms: blurred vision, head/neck pain, fatigue, and sleep disturbance

• Symptoms worsen during studying or examinations

• Observed primarily among West African students

• Academic stress → cognitive + physical symptoms

Dhat

Severe anxiety and hypochondria related to the belief that semen loss causes physical weakness

• Fear that semen loss through urine, nocturnal emission, or masturbation weakens the body

• Associated with fatigue, sexual dysfunction, anxiety, dysphoria, weakness, and depression

• Commonly observed among Indian men and South Asian populations

• Hallmark: Fear of semen loss

• Represents a cultural explanation of distress

Shen-k'uei (Shenkui Syndrome)

Anxiety and physical weakness attributed to loss of semen and depletion of vital life energy

• Chinese culture-bound syndrome

• Belief that semen loss depletes jing (vital life energy)

• Semen loss may be attributed to masturbation, nocturnal emissions, or sexual intercourse

• Symptoms: fatigue, weakness, dizziness, anxiety, palpitations, back pain, and sexual dysfunction

• Origin: China

Ghost Sickness

Death-related distress involving preoccupation with the dead and belief that spirits can cause illness

• Preoccupation with death and the deceased

• May involve prolonged/pathological grief or depression

• Belief that contact with the dead or spirits causes illness

• May occur after losing a loved one

• Commonly observed among Native Americans

• Death-related distress + spirit beliefs

Hwabyung

Suppressed anger that manifests as psychosomatic symptoms, dysphoria, anxiety, and panic

• Literally means “anger illness”

• Individuals internalize anger rather than expressing it

• Symptoms: epigastric pain, muscular aches, loss of appetite, sleep disturbance, palpitations, breathlessness, dysphoria, anxiety, and panic

• Origin: Korea

• Common among middle-aged Korean women

• Hallmark: Suppressed anger → psychosomatic symptoms

Shenjing Shuairuo

“Weakness of the nervous system” involving fatigue, irritability, headaches, and sleep problems

• Origin: China

• Combines concepts from Traditional Chinese Medicine with the Western concept of neurasthenia

• Symptoms include mental fatigue, feeling vexed/irritable, excessive worry, headaches, and insomnia

• Often associated with work or family stress, failure, loss of face, or excessive worry

• Traditionally understood as an imbalance or depletion of vital energy (qi)

• Hallmark: Physical and mental “weakness” associated with stress and worry

Uppgivenhetssyndrom

“Resignation syndrome” characterized by coma-like withdrawal and refusal to move, talk, or eat

• Translates to “resignation syndrome”

• Characterized by coma-like symptoms

• Individual may refuse to move, speak, or eat

• Affects refugee children from former Soviet or Yugoslav states living in Sweden

Koro

Acute anxiety and fear that the penis is shrinking and retracting into the abdomen, potentially causing death

• Intense fear of genital retraction

• Belief that retraction will result in death

• Observed mainly in Asia, particularly China

Saora

Memory loss, fainting, and inappropriate crying or laughing attributed to supernatural beings

• Characterized by memory loss, fainting, and inappropriate crying or laughing

• Occurs in response to social pressure to live a certain way

• Attributed to supernatural beings who want to marry the afflicted person

• Origin: Saora tribe of Southeastern India

Maladi Moun

Belief that illness or misfortune is caused by another person’s ill intent, envy, or hatred

• Translates to “humanly caused illness”

• Illness may be attributed to spiritual means or “sending illness”

• Similar to the concept of the evil eye

• Origin: Haiti

Clinical Lycanthropy

Delusion that one has transformed into or is transforming into an animal

• Involves delusions of animal transformation

• Can occur across various cultures

Piblokto

Abrupt dissociative episode involving social withdrawal, wild behavior, convulsions or stupor, and amnesia

• Also called Arctic hysteria

• Phases:

  • Prodrome → social withdrawal

  • Excitement → wild behavior and stripping clothes

  • Convulsions/Stupor

  • Recovery → amnesia

• Origin: Arctic regions

Latah

Exaggerated startle response accompanied by trance-like dissociation and automatic behaviors

• Exaggerated startle response

• May involve echolalia and echopraxia

• Associated with trance-like dissociation

• Also known as Imu, Mali-Mali, and Jumping Frenchmen of Maine

• Observed in Southeast Asia and Japan

Jikoshu-Kyofu

Fear of having an offensive body odor despite no actual offensive odor

• Also known as Olfactory Reference Syndrome

• Translates to “fear of self-odor”

• Preoccupation with the false belief that one emits an offensive body odor

• Associated with intense self-consciousness about perceived odor

Khyâl Cap

Panic-like attacks attributed to “wind” rising through the body

• Origin: Cambodia

• Symptoms include dizziness, palpitations, shortness of breath, cold extremities, tinnitus, and neck soreness

• Individuals believe khyâl, a wind-like substance, rises through the body and can cause serious or fatal consequences

• Attacks may be triggered by worry, standing up, certain odors, crowded places, or riding in a car

• Hallmark: Panic symptoms explained by wind rising through the body

Susto

Distress attributed to a frightening event that causes the soul to leave the body

• Origin: Latinx cultural contexts in North, Central, and South America

• Also known as “fright” or soul loss

• Belief that a frightening event causes the soul to leave the body, resulting in sickness and difficulties functioning

• Symptoms may include sadness, low self-worth, sleep/appetite disturbances, lack of motivation, headaches, stomachaches, and muscle pain

• Symptoms may appear days to years after the frightening event

• Hallmark: Fright → soul loss → psychological and physical distress

Ataque de Nervios

Intense emotional upset with a feeling of losing control, often involving crying, screaming, anxiety, anger, or aggression

• Origin: Latinx cultural contexts

• Symptoms may include acute anxiety, anger, grief, uncontrollable crying/screaming, trembling, and aggression

• Some episodes may involve dissociation, amnesia, fainting/seizure-like episodes, or suicidal behavior

• Often triggered by family-related stress, such as death of a relative or conflict with a spouse/children

• Hallmark: Intense emotional reaction → loss of control, usually following a stressful event

Kyol Goeu

Panic attacks and fainting attributed to excessive wind or gas in the body

• Translates to “wind overload”

• Belief that excessive wind or gas can cause blood vessels to burst

• Characterized by orthostatic syncope or fainting

• Particularly prevalent among Khmer refugees in the United States

Pa-Leng

Pathological fear of cold and wind believed to cause fatigue, impotence, or death

• Fear of cold = frigophobia

• Fear of wind = anemophobia

• Belief that exposure can cause fatigue, impotence, or death

• Chinese and Southeast Asian culture-bound syndrome

Zou Huo Hu Mo

Dissociative and paranoid symptoms experienced during or after qigong practice

• Chinese idiom describing obsession or possession

• Characterized by undesirable somatic or psychological symptoms

• May involve dissociation and paranoia

• Occurs during or after qigong practice

• Translates to “walking fire enters demon”

Shinbyeong

“Spirit sickness” involving anxiety, somatic complaints, and possession by ancestral spirits

• Also called “divine illness”

• Characterized by anxiety and somatic complaints

• Involves possession by ancestral spirits

• Linked to Korean shamanic tradition

• Origin: Korea

Taijin Kyofusho

Extreme fear of offending or embarrassing others through one’s appearance or bodily functions

• Disorder involving fear of offending others

• Extreme self-consciousness about appearance and behavior

• Fear that one's body parts or functions are offensive or embarrassing to others

• Origin: Japan

Ufufunyane

Spirit-possession syndrome involving sobbing, paralysis, trance-like states, and other unusual symptoms

• Attributed to magical potions, demons, or spiritual possession

• Symptoms include sobbing, paralysis, temporary blindness, trance-like states, loss of consciousness, and sexually themed nightmares

• Prevalent among Zulu- and Xhosa-speaking communities in Southern Africa

Amafufunyana

Spirit-related explanation for aberrant behavior and psychological symptoms involving voices from the stomach

• Used by Xhosa traditional healers to explain aberrant behavior and psychological phenomena

• Often associated with schizophrenia

• Belief that the person's stomach speaks in a language they do not understand

• Stomach may issue threats and commands

• Other symptoms: fatigue, nightmares, sleep difficulties, and agitation

• Observed among Zulu and Xhosa communities in South Africa

Hikikomori

Severe and prolonged social withdrawal in which the individual avoids leaving home and has little or no in-person interaction

• Origin: Japan

• Commonly involves adolescents or young adults, particularly males

• Individual may remain in their room and avoid school, work, and face-to-face social interaction

• Often associated with loneliness, limited social networks, and heavy Internet use

• Hallmark: Extreme social withdrawal lasting 6 months or longer

• May occur independently or alongside another mental disorder

Wendigo Psychosis

Insatiable craving for human flesh accompanied by an obsession or delusional belief about becoming a ____ (a legendary, malevolent cannibalistic spirit or monster rooted in the traditional folklore of North American Algonquian-speaking Indigenous peoples, symbolizing winter, starvation, and extreme greed.)

• Insatiable craving for human flesh, even when other food is available

• May range from fear to delusional belief

• Can involve suicidal or homicidal thoughts

• Mainly associated with Northern Algonquian peoples

Zār

Spirit-possession syndrome involving dissociative episodes or altered states of consciousness

• Culture-bound syndrome/spiritual possession practice

• Prevalent in Northern and Eastern Africa and the Middle East

• Belief that individuals are possessed by spirits

• May result in dissociative episodes or altered states of consciousness

• Some individuals develop long-term relationships with the possessing spirit

Kufungisisa

“Thinking too much” involving excessive rumination and worry that causes or reflects psychological distress

• Origin: Shona people of Zimbabwe

• Functions as both an idiom of distress and a cultural explanation for problems

• Involves ruminating on upsetting thoughts and worries, including concerns about physical illness

• Often connected to marital problems, financial difficulties, unemployment, or other social stressors

• Associated with anxiety, excessive worry, panic attacks, depression, irritability, and PTSD

• Hallmark: “Thinking too much” → rumination/worry → emotional and somatic distress

Dissociative Trance

Temporary alteration of consciousness, identity, or awareness associated with trance states

• Characterized by temporary changes in consciousness, identity, or awareness

• Considered a counterpart of Dissociative Identity Disorder (DID) in some Eastern cultural contexts

Maladi Dyab

Belief that illness is caused by others’ envy or supernatural harm

• Origin: Haiti

• Illness is believed to be “sent” by others through sorcery

• May explain psychosis, depression, or other problems

• Similar to the evil eye

Sekimen-kyofu

Fear of blushing or showing embarrassment in front of others.

Shubo-kyofu

Fear that one's body or physical appearance is defective or unattractive.

Jikoshisen-kyofu

Fear that one's gaze or eye contact is offensive or disturbing to others.

Nervios

General state of vulnerability to stressful life circumstances accompanied by emotional and physical symptoms

• Origin: Latinx cultural contexts

• May involve headaches, neck tension, irritability, gastrointestinal problems, sleep difficulties, nervousness, crying, poor concentration, trembling, tingling, and dizziness

• Can range from normal responses to stress to symptoms resembling anxiety, depression, dissociation, or somatic disorders

• Functions as both an idiom of distress and a cultural explanation for psychological suffering

• Hallmark: Broad physical + emotional response to stressful life circumstances

Iich'aa

Sudden violent rage or aggressive behavior associated with amnesia

• Hallmark: Uncontrollable violent/aggressive outburst → amnesia afterward

• May involve attacking people or destroying property

• Similar to Amok, which is why it appeared among the related conditions in your notes

• Key idea: Violent rage + amnesia

Colerina / Mal de Pelea

Culture-bound syndromes involving intense anger or violent emotional outbursts

• associated with anger/rage and physical symptoms attributed to excessive anger.

• literally associated with “fighting” or conflict and involves aggressive/violent behavior.

• Both are listed as related conditions to Amok in your notes.

• Key idea: Anger/conflict → intense emotional or aggressive reactio