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Problem 7 of CCP minor
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Problem 7: Mental Health Cross-cultural differences in views of mental health, and culture-bound vs. universal syndromes
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33.1 P7: Mental HealthHeine: Chapter 14 – ‘Mental Health’ in Cultural Psychology
Hikikomori = social withdrawal (don’t know if this is important?)
- At least 6 months asocial state, not participating in education/employment, no
intimate relationships w/anyone outside of immediate family.
- Other psychiatric disorders cannot explain the primary symptom of withdrawal.
- Usually first appears among Japanese students (typically boys) at junior high/high
school age when they no longer want to go to school (sometimes in response to
bullying) or don’t want to have social interaction w/anyone.
- Sufferers often take out frustration on parents
- Homogeneity of Japanese provides clear role expectations, so if one feels they can’t
meet these expectations, they feel great pressure to fit in
Sociocultural changes in Japan that may have caused this:
1. Decreasing valuation of work due to relative economic comfort of Japan
2. Spread of more lenient & overprotective parenting norms
3. Decline in birth rate that has allowed children to have their own bedrooms
4. Restructuring of labour market that has eroded security & predictability of career
opportunities
5. Most common w/eldest sons, who carries a lot of family pressure
Why is it particular to Japan?
- Causes of disorder less likely to be present everywhere else
- Reactions of parents to hikikomori suffers emerge differently across cultures, e.g.
Americans would take more direct approach. Direct approach has been argued to
make condition worse, driving sufferer into violence/suicide.
What is a psychological disorder?
- Field of psychiatry developed in the West, cannot always be applied in other cultures
Culture-Bound Syndromes
Those that appear to be greatly influenced by cultural factors, so occur less frequently, or
manifested differently, in different cultures (e.g. cases of hikikomori/dhat). Recognised only
within specific culture.
In other cultures, the symptoms that characterise them are largely absent/do not cluster
together, do not occur in same kinds of circumstances, or do not appear at the same frequency
Eating Disorders
- Rates of both anorexia & bulimia have gone up worldwide
- Changing cultural norms, cultural messages: e.g. models, magazines telling women to
lose weight
- Bulimia more prevalent in societies with Western cultural influences
- Anorexia more common in the West, but not so much in other places
But other studies have found evidence of anorexia in societies w/very little Western
influence
In some cultures, patients don’t show any fear of fatness, which is a key symptom of
anorexia in the West. In Hong Kong, more likely to claim they stopped eating bc of
lack of appetite/feeling bloated
- One take is that people w/temperaments that predispose them to anorexic symptoms
are attracted to this lifestyle (inherited predisposition?)
, - Bulimia is culture-bound, but some symptoms of anorexia seem universal, but still
influenced by culture. May be existential universal; present everywhere, but
frequency varies across culture. Not functional universal bc similar motivation (i.e.,
self-starvation) is associated w/different ends (avoiding becoming overweight vs.
being spiritual)
Koro
- East Asia, most common in men; fear of penis shrinking into one’s body. Believed to
have harmful consequences, e.g. death, anxiety, etc.
Can manifest in women as a fear of nipples shrinking into body
- Culture-bound syndrome, bc symptoms nearly absent in all other cultures, but not
clear what cultural factors affect its prevalence.
May be grounded in classical Chinese medicine account of how imbalance of yin &
yang can cause genitals to retract. However, some Americans high on marijuana have
reported having similar fears of having their penis shrink into their bodies
Amok
- Southeast Asian cultures: ‘acute outburst of unrestrained violence, associated
w/indiscriminate homicidal attacks, proceeded by period of brooding, ending
w/exhaustion & amnesia’
- Mostly males: caused by stress, lack of sleep, alcohol consumption
- Malay culture: very passive, non-confrontational. People unable to express their
frustrations ultimately explode in a fit of rage
- Most symptomology of amok is specific to Southeast Asia, but some familiar
phenomena, e.g. mass killings in Western places // Western mass killings more
premeditated, not clear if indicative of underlying disorder
Hysteria
- Drop in prevalence over the years, perhaps bc of patients w/hysteria-like symptoms
being diagnosed w/other disorders, e.g. dissociation, schizophrenia
- Hysteria’s prevalence in 19th century could have been response to repressive social
norms of Victorian Europe disorder gained attention, so people expressed their
distress via symptoms they were familiar with
- Debate as to whether hysteria can be considered culture-bound or just reflection of
changing classification systems of psychiatry
Universal Syndromes
Highlight the biological foundation of mental illness
Depression
- Prevalence of MDD varies depending on specific criteria that are applied in making
diagnosis
- Bipolar disorder also characterised by presence of depressive episodes, but also
experience manic episodes. Prevalence of bipolar highest in English-speaking
countries, lowest in Asia
- Greater cross-cultural variability in prevalence rates for depression than for bipolar
disorder
- Cultural differences in extent to which people emphasise psychological vs.
physiological symptoms of depression.
In general, people are said to be experiencing somatisation to the extent that they are
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