Classification Systems - Parker et al

Parker et al; AIM

To investigate the sociocultural differences in symptoms and diagnosis of depression.

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To compare the extent to which depressed Chinese patients in Malaysia and White patients from Austrailia identifed both cognitive aspects of depresseion and a range of somatic symptoms as a sign of their depression and the reason they seeked out help.

Parker et al; SAMPLE

• Malaysian participants of Chinease heritage.

• Austrailian participants of Western heritage.

The Austrailians all had English as their 1st language, it was split with the participants with language.

All participants in this study were out-patients who were diagnosed with major depressive disorder

• A patient who goes to a healthcare facility for diagnosis without spending the night.

Parker et al; QUESTIONAIRE

The questionnaire was based on 2 sets of symptoms.

1. a set of mood and cognitive items common in Western diagnosti tools for depression.

2. a set of somatic symptoms commonly observed by Singaporean psychiatrists.

This questionnaire was back translated to ensure it’s credibility.

Parker et al; PROCEDURE

The participants were asked to judge the extent to which they had experienced each of the 39 symptoms in the last week.

They only had 4 options:

1. All the time

2. Most of the time

3. Some of the time

4. Not at all

They were also asked to rank these symptoms that they experience in order to how distressing they were.

Parker et al; RESULTS

Looking at the symptom that led them to actually seek help.

• 60% of the Chinese participants identified with the somatic symptom rather only 13% of the Austrailian participants

There was no significant differnece in the number of somatic symptoms indicated by each group as being linked to their depression.

• However, Chinese participants were significantly less likey to identify cognitive or emotional symptoms as apart of their problem.

Parker et al; WHAT DOES THIS SHOW

The role of culture is evident here. In Western culture it is more appropriate to discuss one’s emotions and depression is seen to be linked to a lack of emotional well-being.

Whereas in Chinese culture, it’s less appropriate and even more stigmatized if one speaks about a lack of emotional health.

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Parker et al; APPROACH ETIC

This study used an etic approach to research.

* In this study, they did choose participants based on the DSM 4 criteria for diagnosing Major Depressive Disorder. This study demonstrates an imposed etic approach to research.
* It may have eliminated people from the sample who may have had a form of depression but it did not meet the Western criteria for diagnosis;
* this may account for the similarities in the 2 samples.

Parker et al; EVALUATION

• Attempted to develop a questionnaire based on cultural evidence relevant to the participants. They didn’t use the standardized Western questionnaire and this could have affected the results.

• Asking patients to recall their “first symptoms” is open to memory disortion and to demand characteristics. If in the West we may think depresssion is an emotional disorder, patients may expect that this is the correct response.

• Research on more cultures would be neccessary to test the reliabilty of the findings as Malyasia is a very modern and Westernized society.