Clinical & Issues and debates - Cross cultural studies

What do we mean by cultural issues?

They reflect how the norms and values of different people and lifestyles, that can account for behaviours, are viewed by others

How many studies in an america textbook were performed by:

Americans

Europeans

Rest of the world

Americans - 94%

Europeans - 2%

Rest of the world - 3%

Why do we need to do cross-cultural research?

We cannot assume that results from one country will apply to another, however this is currently how research is used

Give an example of how cultural differences can impact perception of disorders.

Hearing voices can be abnormal but in some religions it can be a sign of talking to god

How can clinicians be biased when diagnosing mh disorders?

Clinicians can be influenced by their cultural norms (ethnocentric)

What is ethnocentricism?

A form of bias wherein individuals believe that their own culture, with all its values, practices, and beliefs, is superior to all other human cultures

How can diagnostic manuals be biased?

As they are created by western cultures, based on studies on western people, results cannot be applied to other cultures with different norms and values

How have diagnostic manuals tried to mitigate the effect of cultural bias?

DSM-5 includes culture related diagnostic issues and outlines how cultural context must be considered

What did Cooper et al find to do with culture and diagnosis?

New York psychiatrists twice as likely to diagnose schizophrenia than London psychiatrists, when shown the same video-taped clinical interviews, suggesting cultural difference

What did Lin and Cheung find to do with culture and diagnosis?

Claimed that due to Asian traditions of viewing the body and mind as unitary, patients tend to focus more on physical discomforts than emotional symptoms, leading to an over-representation of bodily complaints

What are the barriers to communication which can influence cultural bias?

- Gaining trust of informants

- Understanding of informants language and meanings

- Relying on interpreters

- Cultural rules/standards

What would be the best way to measure disorders within cultures?

Going to the place, immersing yourself in the culture and speaking to the doctors and patients there. These are called cross cultural studies

What are cross cultural studies?

Comparison of one culture with one or more other cultures

Why is it difficult to perform cross cultural studies?

Logistics of the study (getting there, costs, funding etc)

What are some issues with interpreters?

- Some languages cannot be directly translated (miss some of the meaning)

- Translators could modify responses through their own lenses (unconscious bias)

What is the cross cultural study we do?

Luhrmann (2014)

What was Luhrmann's study on?

Do all cultures experience S1 in the same way?

Who were Luhrmann's pp?

20 pp in America

20 pp in India

20 pp in Ghana

All pp had S1

What was Luhrmann's procedure?

She asked the pp about their perceptions of voices they had heard

What similarities did Luhrmann find?

The experiences of voice hearing was very similar:

- Many reported conversations with their voices

- Many said god had spoken to them

- There were some in each setting who hated their voices

What differences did Luhrmann find?

- Many pp in India and Ghana said their voice(s) were positive and that they had human relationships with their voices

- None of the american pp had this. Their experiences were more violent and harsh

What did Luhrmann conclude about S1?

That in non-western countries, the outcome of S1 was less severe. She concluded that the experience of the disease was shaped by cultural norms and values