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Lesson Module - 9 - Mental Health - Part - 2 (1)

MENTAL HEALTH

CULTURE-BOUND MENTAL HEALTH SYNDROMES

  • Definition: Disorders found primarily within specific cultures with no direct counterparts in other cultures.

Amok

  • Description: A syndrome characterized by brooding followed by sudden, indiscriminate violent behavior, primarily found among people in Malaysia.

  • Historical Background:

    • Believed to be caused by the entry of an evil spirit, particularly a hantu belian (evil tiger spirit), which prompts rampage.

  • Diagnostic Symptoms:

    • Episodes begin with brooding, followed by a violent rampage.

    • Often concludes with the perpetrator in a state of exhaustion and amnesia post-incident.

    • Uniquely different from mass shootings in that it is rarely premeditated.

Potential Causes

  • Cultural Factors:

    • Reflects a clash within Malay culture—a typically passive approach with few means of expressing frustrations often leads to explosive anger.

    • Common triggers include stress, alcohol use, and lack of sleep preceding episodes.

  • Therapeutic Interventions:

    • No recognized treatment specific to Amok; focuses more on managing triggers and underlying cultural frustrations.

Other Facts

  • Demographics:

    • Primarily affects men; most individuals who run amok are killed in the act.

  • Historical Note: Increased prevalence noted in the late 20th century; specialized weapons developed for police intervention in such incidents.

  • DSM-V Note: Amok is no longer classified as a culture-bound syndrome since the latest DSM edition.

Dhat Syndrome

  • Description: A disorder seen in young men, primarily from the Indian subcontinent characterized by anxiety over perceived semen loss leading to feelings of weakness.

Historical Background

  • Cultural Beliefs:

    • Hindu scripture denotes the importance of semen as a source of masculinity and vitality, linking dietary habits to reproductive fluids.

Diagnostic Symptoms

  • Morbid preoccupation with feelings of guilt regarding seminal loss associated with masturbation or nocturnal emissions.

  • Symptoms include insomnia, feelings of weakness and depression.

Potential Causes

  • Cultural Norms: Stigma around sexual activity and health, contributing to anxiety about semen loss.

  • Therapeutic Interventions:

    • Cognitive-behavioral therapy and potentially anti-anxiety medications.

Koro

  • Description: A delusional belief that one’s genitalia are retracting and will disappear, prevalent in Southern China and other regions.

Historical Background

  • Belief may stem from interpretations of yin-yang imbalances in traditional Chinese medicine.

Diagnostic Symptoms

  • Strong belief in genital retraction and accompanying anxiety, including fears of death.

Therapeutic Interventions

  • Psychotherapy focused on reassurance and education regarding anatomy.

Hikikomori

  • Description: Characterized by extreme social withdrawal, prevalent among Japanese youth.

Historical Background

  • Linked to Shinto mythology, notably the tale of Amaterasu, who isolated herself in a cave.

Diagnostic Symptoms

  • Criteria:

    • Withdrawal for a minimum of 6 months from work or education; no intimate relationships outside of family; onset before late 20s.

Potential Causes

  • Cultural shifts leading to overprotective parenting and declining birth rates contributing to social withdrawal.

Therapeutic Interventions

  • Use of "rental sisters" or "rentaru oneesan" to build rapport and trust, gradually helping individuals re-engage with society.

  • Other Facts: Affects mainly junior high/high school students, often linked to bullying; high risk of violence or suicide; estimated 1 million affected in Japan.

CROSS-CULTURAL APPROACHES TO MENTAL HEALTH

  • Mental illness protocols vary across cultures; studies show social support helps coping.

Differences in Seeking Support

  • East Asian vs. European American:

    • East Asians often seek implicit support (emotional comfort without problem disclosure); European Americans favor explicit support (active discussion and seeking help).

  • Study Findings:

    • East Asians may display lower stress reactions, with social support being less associative to stress response than in Western cultures.

  • In collectivist cultures, maintaining social networks is prioritized, impacting help-seeking behaviors.

Treatment Paradigms across Cultures

  • Western Approaches:

    • Originated with psychoanalysis by Freud; evolved into client-centered therapy by Carl Rogers, focusing on self-exploration.

  • Cognitive-behavioral therapy (CBT) is also prominent, targeting cognitive distortions and changing behaviors through structured techniques.

Eastern Approaches

  • Morita Therapy: Action-oriented, focuses on acceptance rather than direct change. Involves stages from rest to complex activities integrated with mindfulness practices.

  • Naikan Therapy: Self-reflective approach that emphasizes gratitude and acknowledgment of reliance on others.

Traditional Approaches

  • Kinship Model: Focus on family/community dynamics to promote well-being and manage mental health stigma.

  • Religious-Spiritual Model: Includes practices from traditional healers addressing mental ailments through spiritual methods.

Social Constructs of Mental Illness

  • The introduction of Western psychological concepts can influence local understandings and potentially increase disorders not originally recognized in non-Western cultures.

  • Case Studies:

    • Discrepancies observed where symptoms previously unnoticed become recognized post-importing specific diagnostic concepts, suggesting cultural sensitivity is paramount in treatment effectiveness.