Cultural Issues in Psychopathology

Cultural Issues in Psychopathology 

By:  Kimberly Swanson, M.S. - Psychology, CNA

In todays’ society, there is stigma or negative connotation when it comes to seeking and receiving mental or psychological services.  Often times, these negative point of views towards mental health stems from cultural beliefs.  It is apparent that cultural issues are attributed to depression and cultural issues and is also a major factor to the treatment of depression.

Understanding Culture and Mental Illness

The beginning stages of incorporating culture into clinical psychological research started with Kleinman (1977). Kleinman (1977) believed that culture is the basis of human behavior especially when it comes to “mood disorders”.  Fields (2010) states that, clinicians need to be understanding and mindful of patients’ culture while treating them.  There are two points of views, when it comes to culture and depression (Fields, 2010).  The two points of views are:   1. “universal views” – It applies to all cultural lines and can be measured with proven evidence;    2.   “cultural-bound” views - is based on a specific culture and cannot be measure (Field, 2010).

In Field’s (2010) research, it shows the current views on “multicultural competence, the American Psychological Association (APA) Multicultural Guidelines” which points out the different cultural views on mental health and the “cross-cultural validation of depression”.  According to Fields (2010), cultural definition and “interaction” is constantly changing and evolving.

Identifying culture as an intricate part of in the care of mental patients is a new phenomenon that is taking place within psychological research (Fields, 2010).  The purpose of incorporating culture into psychological research is to address the complex issues that are often found when working with a diverse population (Fields, 2010).

Examples of Culture Issues & Depression

Asian Pacific Views on Depression

In the MyPsychLab (2013), “Martha: Major Depressive Disorder” video, it discusses how depression is viewed from an Asian Pacific patient name Martha.  Martha suffered from depression due to a failed marriage.  At first, Martha did not seek treatment because of her cultural issues.    Nira Singh (Director of children youth and family outpatient services of RAMS Mental Health Agency) mentions that, “there is a stigma for most Asian Pacific clients who utilize the services”.  Getting medical help is seen as more important than getting psychological assistance (MyPsychLab, 2013).  Traditional families of Asian Pacific Islanders may see treatments as shameful depending on their view on mental health (MyPsychLab, 2013).

Nira Singh mentions that, “often times that patients do not know that these services are available to them and is available in their native language” (MyPsychLab, 2013).  In the video, Singh also states that: “as model minorities, you are not suppose to have mental problems…There is a feeling of shame when acknowledging a weakness” (MyPsychLab, 2013).  More outreach is needed in educating the public on depression and how it affects people’s lives.

Bosnian Views on Depression

In Fields’ (2010) research, there were many examples on how different cultures view depression.  One example is a case, “The Case of G,” about a Bosnian refugee who suffered from the posttraumatic stress disorder (PTSD).  The patients’ PTSD was triggered by war and “the tragic losses” that he had to face in “his home country”. G did not have to a psychologist or therapist in Bosnia because of negative cultural views.  The patient views himself as a “traditional man” and in his country, seeing a therapist often times means that you are “crazy” (Fields, 2010).   He was concerned about being viewed as crazy by others.  For the Bosnian refugee, not being able to speak English was also a perceived barrier.  Having this perceived language barrier makes the patient of a different culture feel “inadequate” (Fields, 2010).

In G’s case, there was a need for social interactions.  According to Fields (2010), the patient’s plan of care was mostly geared for “cultural dynamics” instead of starting an initial “treatment plan”.  Once G received the support of getting more social interactions with peers with similar cultures and backgrounds, G’s condition greatly improved (Fields, 2010).

How Cultural Issues Affects Treatments for Depression

The American health care system is fragmented.  These fragmentations makes is extremely difficult for patients to receive the proper treatment for depression.  Doctors, mental “health professionals”, “patients”, and “families” face the dilemma of a divisive system that separates the “medical and mental health” in its treatment options and line of care (Heinrich, 2000).  By bridging and incorporating the medical with the psychological, there would be a more balanced and improved system of care for mental health patients, especially those who are suffering from depression (Heinrich, 2000). 

Overcoming perceived cultural differences in patients when it comes to their line of care is also extremely important.  Clinicians must be able to understand their client’s culture in order to provide the patients with the best treatment options for depression.  Each case for depression is different and must be treated as so.   Getting into the mind of the patient and seeing from their point of view enables the mental health professional to better serve their clients.  Clinical research and case studies like Fielding, (2010) and Heinrich (2000) has shown  that understanding a patient’s culture means getting to the root  of the problem.  This ideology of culture is paving the way for a more positive solution for patient care and for improving their overall mental health. 

References

Fields, A.J. (2010).  Multicultural research and practice:  Theoretical issues and maximizing cultural

Exchange.  Professional Psychology:  Research and Practice, 41(3).  196-201.  Doi:10.1037/a0017938.

Heinrich, R.L. (2000).  Improving depression care:  Disseminating skills or changing organizational

structure and culture?  Families, Systems, & Health.  18(4). 

Kleinman, A.M. (1977).  Depression, somatization and the “new cross-cultural psychiatry.”

MyPsychLab, Pearson Video Series .  (2013).  Speaking Out: The DSM in Context: Martha:

Major Depressive Disorder [on-line video].  Available from

www.pearsonmylabandmastering.com.


Copyright in 2015 by ©Messenger Publishing, Inc.

Symptoms and Etiology of Anorexia Nervosa

By:  Kimberly Swanson, M.S. - Psychology, CNA

All over the world, there  are various views and ideology of what is considered beautiful especially when it comes to body images.  For example, in some African countries such as Nigeria,  a woman who has a few extra pounds or curves is considered attractive.  But in other countries such as the United States, being skinny  or thin is what is considered beautiful.  This strong powerful message of the standard of beauty is often times depicted in the media and is forever etched into the minds of women and female adolescents.  Professional models that grace the covers of fashion magazines are extremely thin and often times appear to be malnourished.  There have been some cases in the modeling industry where anorexia is a growing medical issue.  Some models starve themselves in an effort to try to keep up with the body image of the being extra thin.

"The average woman is 5”4’ and weighs 140 pounds. The average model is 5”11’ and weighs 117 pounds. Most fashion models are thinner than 98% of American women" (Smolak, 1996). 

History of Anorexia

Anorexia is not a new phenomenon that has occurred in modern times; it has been first identified in the late 1800’s by Charles Lasegue in Paris and Sir William Gull in London (Butcher, 2013).  This condition is more prevalent among women than men.    Tolman (1932) first developed the expectancy  theory in which “social  learning experiences” are developed into the ideology  that  a behavior has to be done continuously in order to fit into society.  There are many more current clinical studies done on the etiology of  anorexia (e.g. Eagles' et al., 2006, a case study on family composition in anorexia nervosa) and another modern research (e.g. Annus et al., 2008) on the etiology of eating disorders.  

Symptoms & DSM-5 Criterion for Anorexia

According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), there are three criterion for the symptoms of anorexia.  The three  major symptoms for the diagnosis for  anorexia in DSM-5 are:  1.  “Restriction of energy intake”, 2.  “Intense fear of gaining weight”,  and  Interruption of  “body weight  or shape experienced” (APA, 2013).   

Etiology of Anorexia

Current studies has shown that the cause of eating disorders stems from the social ideology  the  being in control of your weight in order to be thin is what  really matters (Hohlstein, Smith, & Atlas, 1998).  According to Stice (2002), expectancy theory  is the learned behaviors that is based  on the ideology that being thin is important and is needed  in order to boost confidence and self-worth.  It is believed that the family makeup is a major contributing factor in to eating disorders (Eagles et al., 2006).  There is a correlation in family structures such as biological and sociocultural factors when it comes to eating disorders (Eagles et al., 2006).

Before (Annus et al., 2008) study, it is believed that women with anorexia nervosa supported  the idea that in order to be thin is to restrict food intake.  The intervention of changing the patient’s mindset on “expectancy” has been met with the success in previous research.  Even though, studies do not show proof that changing mind sets or personal beliefs reduces anorexia, results from previous studies show consistency in the effectiveness in reducing patient’s negative attitudes and reactions (Annus et al., 2008). 

  

References

American Psychiatric Association. (2013).  Diagnostic and statistical manual of mental disorders (5^th ed.).  Washington, DC:  Author.

Annus, A., Smith, G., Masters, K. (2008).  Manipulation of Thinness and Restricting Expectancies in the Etiology of Eating Disorders.  Psychology of Addictive Behaviors.  22(2), 278-287.

Brown, T. A., & Barlow, D. H. (2011).  Casebook in abnormal psychology (4^th ed.).  Belmont, CA: Wadsworth.

Eagles, J., Johnston, M., & Millar, H. (2005). A case-control study of family composition in anorexia nervosa. The International Journal Of Eating Disorders,38(1), 49-54.

Hohlstein, L.E., Smith, G.T., & Atlas, J.G.  (1998).  An application of expectancy theory to eating disorders:   Development and validation of measures of eating and dieting expectancies.  Psychological Assessment, 10(1), 49-58.
Smolak L. (1996). National Eating Disorders Association/Next Door Neighbors puppet guide book.

Stice, E. (2002).  Risk and maintenance factors for eating  pathology:  A meta-analytic review.  Psychological Bulletin, 128(5), 825-848.

Toman, E.C. (1932).  Purposive behavior in animals and men.  New York:  Century.

Additional Source

The Alliance for Eating Disorders Awareness. (2015).  Eating disorder statistics.  Retreived from https://www.ndsu.edu/fileadmin/counseling/Eating_Disorder_Statistics.pdf.

Copyright in 2015 by ©Messenger Publishing, Inc. 

Word of the Week - Psychopathology

Psychopathology - [psy-cho-pa-thol-o-gy] (noun) - The scientific study of the mental and behavioral disorders.  Adjectives - psychopathologic, psychopathological