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Psychology 307:
Cultural Psychology
Health
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Health
1. What is a psychological disorder?
2. What psychological disorders are universally
recognized?
3. What psychological disorders are culture-bound?
4. Are Western psychotherapeutic approaches
effective for the treatment of psychological disorders
among individuals living in non-Western cultures?
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What is a psychological disorder?
● Consider the following scenario:
A woman is in the midst of a group of people but
seems totally unaware of her surroundings. She is
talking loudly to no one in particular, is often using
words that people around her find unintelligible, and
is occasionally barking. When later questioned
about her behaviour, she reports that she was
talking with a man who had recently died and had
briefly been possessed by the spirit of a dog.
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● Psychological disorders are typically described as
states that:
(a) are statistically rare.
(b) cause subjective distress or impaired social
functioning.
● Cognitive or behavioural patterns that are described
as psychological disorders in one culture may not be
described as psychological disorders in other
cultures.
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● In recent years, researchers have become
increasingly interested in examining differences in
the occurrence and prevalence of psychological
disorders across cultures.
● Their research has demonstrated that there are
psychological disorders that are universally
recognized and psychological disorders that are
specific to distinct cultural groups.
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What psychological disorders are universally
recognized?
1. Depression
 According to the DSM, depression is characterized
by a depressed mood, an inability to experience
pleasure, fatigue, changes in appetite or sleep
patterns, poor concentration, a sense of
worthlessness or guilt, and suicidal ideation.
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 Across cultures, medical practitioners have
identified individuals who display this pattern of
symptoms, suggesting that depression is a
universal psychological disorder.
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 Nevertheless, the prevalence of depression and
the primary symptoms of depression vary across
cultures.
With respect to the primary symptoms of
depression, psychological symptoms are most
frequently reported in some countries (e.g.,
Canada, the U.S.), whereas somatic symptoms are
most frequently reported in other countries (e.g.,
China, Mexico).
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 Several theories have been proposed to account
for cultural differences in the primary symptoms of
depression:
(a) Cultural differences in the social stigma
associated with a psychological disorder versus
a physiological disorder.
(b) Cultural differences in the tendency to attend to
psychological versus somatic symptoms.
(c) Cultural differences in the tendency to view the
mind and body as distinct entities.
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2. Schizophrenia
 According to the DSM, schizophrenia is
characterized by auditory and visual hallucinations,
delusions, disorganized speech, flat affect, and
disorganized or catatonic behaviour.
 Across cultures, medical practitioners have
identified individuals who display this pattern of
symptoms, suggesting that schizophrenia is a
universal psychological disorder.
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 Multinational studies (Colombia, Czechoslovakia,
Denmark, England, India, Nigeria, the Soviet
Union, Taiwan, U.S.; WHO, 1973, 1919, 1981)
indicate that the prevalence of schizophrenia is
similar across countries and has remained
relatively constant across time.
 Across countries, males are more likely to develop
schizophrenia than females.
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 Nevertheless, the primary symptoms of
schizophrenia vary across cultures.
Paranoid hallucinations and delusions (indicative of
paranoid schizophrenia) are most frequently
reported in some countries (e.g., England, the
U.S.), whereas catatonic behaviour (indicative of
catatonic schizophrenia) is most frequently
reported in other countries (e.g., India, Nigeria).
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3. Other disorders
 There are several other psychological disorders
identified by the DSM that are found across
cultures:
Social anxiety disorder
Attention-Deficit/Hyperactivity Disorder (ADHD)
Personality disorders (e.g., antisocial personality
disorder)
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What psychological disorders are culture-bound?
1. Amok
 The most widely observed culture-bound
syndrome, identified in several Southeast Asian
countries (e.g., Malaysia, Indonesia, Thailand).
 More common among males than females.
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 Characterized by wild, aggressive behaviour of
limited duration in which there are attempts to kill or
injure others. Brooding and withdrawal proceed the
outburst. Exhaustion and amnesia follow the
outburst.
 Precipitated by a slight or insult; brought on by
stress, sleep deprivation, and alcohol consumption.
 Hypothesized to emerge in societies that encourage
people to be passive and nonconfrontational; pent up
frustrations erupt as rage.
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2. Pibloktoq (Artic hysteria)
 Identified among Arctic and sub-Arctic Inuit
communities, such as the Greenland Eskimos.
 More common among females than males.
 Characterized by extreme excitement, physical
violence, verbal abuse, and convulsions. Individuals
flee from protective shelters, tear off their clothing,
and expose themselves to the extreme temperatures.
Individuals may imitate the cry of an animal or bird
during the attack.
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 Brought on by environmental conditions (e.g.,
isolation, darkness) and dietary deficiencies.
3. Shinbyeong (Spirit sickness)
 Identified among Koreans.
 More common among females than males.
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 Characterized by a loss of appetite, weakness,
insomnia, dizziness, fear, and gastrointestinal
problems. The symptoms progress to include
mental disturbances: Dreams of communication
with God, hallucinations, dissociation, possession
by ancestral spirits.
 Brought on by a spiritual “calling” to become a
shaman.
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4. Witiko (Windigo psychosis)
 Identified among the Algonquian Indians.
 More common among males than females.
 Characterized by an insatiable desire to eat human
flesh even when other food sources are available.
Individuals are thought to be possessed by the
“witiko spirit.” If the condition cannot be cured,
sufferers often request that they be executed in
order to avoid harming others.
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 Brought on by starvation anxiety.
5. Other disorders
 The DSM recognizes a host of other culturebound syndromes: Ataque de nervios, Brain fag,
Dhat, Frigophobia, Koro, Latah, Locura, Mal de
ojo, Rootwork, Susto, Whakama, and Zar are
among them.
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Are Western psychotherapeutic approaches effective
for the treatment of psychological disorders among
individuals living in non-Western cultures?
● Two evidence-based psychotherapeutic
approaches are frequently used in the treatment of
psychological disorders in Western cultures:
Cognitive-behavioural therapy: Modification of
debilitating thoughts and behaviours.
Interpersonal therapy: Interpersonal skills training.
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● Research has established the effectiveness of
these approaches for treating North Americans of
European descent.
● Moreover, the scant research that has examined
the effectiveness of these approaches with other
cultural groups suggests that they are effective.
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● Nevertheless, there has been an increased
interest among researchers in indigenous
therapeutic approaches.
● Several indigenous therapeutic approaches have
been identified. These approaches are
comparable to CBT and IPT in their effectiveness.
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1. Morita therapy
 Developed in Japan.
 Goal of therapy: To have patients accept reality
rather than attempt to bring reality in line with
personal needs and desires.
 Procedure involves 4 stages:
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(a) Total bed rest and isolation.
(b) The patient is permitted to do light work and
begins to write a diary, but is forbidden from
contact with others.
(c) The patient is permitted to engage in heavier
work and begins to attend lectures on self-control
and the evils of egocentricity.
(d) The patient gradually returns to full social life but
continues to have contact with the therapist.
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2. Naikan therapy
 Developed in Japan.
 Goals of therapy:
(a) The discovery of personal, authentic guilt for
having been ungrateful and troublesome to
others in the past
(b) The discovery of positive gratitude towards
individuals who have extended themselves on
behalf of the patient at some time in the past.
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 Procedure: The patient introspects from 5:30 a.m.
to 9 p.m. for 7 days. The patient is instructed to look
at his/her relationships from 3 perspectives: Care
received, repayment, and trouble caused.
 Interviews are conducted every 90 minutes. The
interviews are conducted in “a boldly moralistic
manner, placing the burden of blame on the client
rather than on others.” (Murase, 1982, p. 318)
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Health
1. What is a psychological disorder?
2. What psychological disorders are universally
recognized?
3. What psychological disorders are culture-bound?
4. Are Western psychotherapeutic approaches
effective for the treatment of psychological disorders
among individuals living in non-Western cultures?
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