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Summary Cross-cultural Psychology of Health and Illness (6463PS023Y)
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Hoorcollege 1 Introduction, research methodsObjectives
This course looks at culture, health, disease, and health care from a psychological perspective and at
cultural aspects of core psychological concepts and models.
After the course, you will have an understanding of how cultural aspects relate to personality,
development, cognition, emotion, social interaction, stress, pain, lifestyles, psychopathology, health
and illness, communication between health care professionals and migrant patients, and the use of
healthcare facilities.
Health and illness
• Positive concept of health and negative concepts of disease/illness/sickness are defined differently
in different cultures
• Culture influences…
o What constitutes health or illness
- Culture-specific illnesses
o What is thought to cause health or illness
- Some cultures take personalistic views, while Western medicine is generally mechanistic
o What should be done for health or against illness
- Habits in terms of seeking health care
- Acceptable health care practices
Culture: what is it?
• Culture can be thought of as a set of implicit and explicit guidelines/information that individuals
acquire as members of a particular society or context, regarding, e.g.
o How to view the world
o How to experience emotions
o How to behave in relation to other people
o To supernatural forces or gods
o To the natural environment
• It also provides a way of transmitting these guidelines to the next generation (enculturation)
→ A “lens” through which the individual perceives and understands the world that he inhabits and
learns how to live with it (Helman, 2007)
→ the group or context itself
Challenges to definitions
• Cultural boundaries are not distinct, often unclear
• Cultures are dynamic and change over time
• There are as many variations within cultures as between cultures!
o Problem with stereotypes: person-related variables are generally continuous and distributed
o Artificial or false dichotomies should be avoided
Three levels of culture
• Tertiary level: explicit manifest culture, visible to the outsider, such as social rituals, traditional
dress, national cuisine, festive occasions… = ‘façade of a culture’
• Secondary level: underlying shared beliefs and rules, known to the insiders but rarely shared with
outsiders = ‘social norms’
• Primary or deepest level: rules that are known to all, obeyed by all, but implicit, and generally
out of awareness (hidden, stable and resistant to change) = ‘roots’
(Cross)-cultural psychology
• Absolutist approach: psychological phenomena are the same across cultures, processes and
behaviors vary
• Relativist approach: psychological phenomena only exist within the context of a culture
,• Somewhere in between: psychological processes are shaped by experience, but all humans share
the same biological constraints
• General psychology focuses on universals and (sometimes) tries to control for cultural variation
• Cultural psychology focuses on cultural variation in terms of the psychological consequences of
culture
o Studies that different meaning systems originating from different environments
o Assumes that mind and culture are entangled
o Assumes that thoughts are shaped by contexts
Universality vs cultural variability
• Whether a process is universal or culturally variable often depends on the level of definition
o Abstract definitions generally lead to evidence supporting
universality
o Concrete definitions generally lead to evidence supporting
variability
Degrees of universality
• Nonuniversal (cultural intervention): cognitive tool not found in all
cultures (other criteria are thus irrelevant)
• Existential universal: cognitive tool found in all cultures that serves
different function(s) and is available to some degree in different cultures
• Functional universal: cognitive tool found in all cultures that serves the
same function(s) but is accessible to different degrees in different cultures
• Accessibility universal: cognitive tool found in all cultures that serves the
same function(s) and is accessible to the same degree
Cultural dimensions theory
Hofstede (2001): Cultures can be distinguished according to five dimensions:
• Individualism–collectivism
o How interdependent is a culture?
• Uncertainty avoidance
o How do people deal with ambiguity?
• Power distance
o How hierarchical is a culture?
• Long-term/short-term orientation
o Connection with tradition, also economic orientation
• Masculinity/femininity
o How distinct are gender roles? Distribution of classical male/female traits
Theoretical constructions!
• Other dimensions are of course possible, and many authors have developed more/different
dimensions
o Not absolute!
o Hofstede is dominant system
• Generalizations: groups also vary in homogeneity!
o Individual differences
o Layers within cultures
Socio-economic status
• SES also has cultural implications!
o Interaction with culture
o Specifically relevant for health
• Differences in health behaviors within western cultures:
, o Smoking: lower SES predicts likelihood of smoking, higher SES predicts recent attempts to
quit
o Lower SES predicts higher alcohol consumption
o Higher SES predicts more balanced and healthy food intake
Dealing with differences
• Color-blind approach
o Emphasizes common human nature, ignores cultural differences
o Research has demonstrated that even trivial distinctions between groups often lead to
discrimination
• Multicultural approach
o Recognizes that group identities are different (particularly minorities)
o Ignoring such group differences tends to lead to negative responses
Error of ethnocentrism
• Recognize our own ethnocentrism
o Perceiving one’s own culture as standard of comparison
o Tendency to judge people from other cultures negatively by comparing them to your own
culture
Current research practice: selection bias (Henrich et al., 2010)
• Who is WEIRD?
o Western
o Educated
o Industrialized
o Rich
o Democratic
• 2003-2007:
o WEIRD subjects make up 96% of all psychology research, but represent only about 16% of
the world population
o 70% of participants are psychology undergraduates
o 99% of first authors come from Western universities
Weird participants
• WEIRD countries only make up about 16% of the world’s population!
• Evidence for WEIRD thinking has been shown by contrasting:
o Industrialized vs. nonindustrialized societies: people react differently
o Western vs. non-Western societies: Western people are more outspoken
o Americans vs. other Westerners: Americans respons more extreme
o University-educated Americans vs. other Americans
Weird subjects: outliers?
• WEIRD group even appears to be particularly unusual, with differences appearing in
o visual perception
o fairness
o cooperation
o spatial reasoning
o categorization and inferential induction
o moral reasoning
o reasoning styles
o self-concepts and related motivations
o heritability of IQ
But also our main source of information!
, (Cross-)cultural psychology
• Aims to better understand the full distribution of human psychology, and the implications of cross-
cultural variation
→ learning about cross-cultural variation helps us to interact in a globalizing world, especially in
multicultural societies
Research methods
• Goals
o Describe: what is happening?
o Explain: why is it happening?
o Predict: what will happen next?
o Change behavior: how can we alter what happens?
• Approaches
o Quantitative
o Qualitative
Practical aspects
• Methodological equivalence: how easily can you apply measures across cultures?
o Cognitive tests?
o Questionnaires?
o Physiological measures?
o Naturalistic observation?
Extensive piloting and validation
Measurement quality: reliability and validity
• Reliability may refer to:
o Reproducibility
o Replicability
o Precision
• Validity may refer to:
o Internal validity
o External validity
o Construct validity
o Ecological validity
Central themes
• Universality of a specific trait
o Often: looking across groups (remember the levels of universality!)
• Influence of a specific trait on thinking and behavior
o Often: looking within (multiple!) groups
• Studying a culture as a whole rather than individuals
o Often: looking at cultural messages (news, media etc. ) for specific traits
• Comparisons: what are the right contrasts?
→ depends on the specific research question!
Instruments
• Surveys
• Experiments
o Behavioral/physiological
• Observation
• Interviews
• Economic games
• Archival work
• Field work
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