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Mental & Physical Health Discussion Describe the following: What would someone with depression experience, feel, or describe? What specific kinds of things do you expect someone with anxiety to feel anxious or nervous about? If someone has a delusion caused by schizophrenia, what would it commonly be? What are the reasons why people commit suicide? Objectives Describe the psychological disorders that are found across cultures. Identify the role that culture plays in the diagnosis of psychological disorders. Identify the role that culture plays in the expressed symptoms and course of psychological disorders. Psychological Disorder A pattern of behavioral and psychological symptoms that causes significant personal distress, and/or impairs the ability to function in one, or more daily areas of life, or causes harm to the self or others. Different than just abnormal – not just a violation of norms or statistically infrequent Depression Recurrent episodes of 5+ of: despair, hopelessness, worthlessness, loss of interest in activities/people, negative selfevaluations, guilt, suicidal thoughts, loss of appetite, sleep disturbances, bodily pain Culture: somatization vs. psychologization East Asia vs. United States Males vs. Females Social Anxiety intense, irrational fear and avoidance of a specific social situation – fear that social ineptitude will have negative consequences Cultural difference: rates lower in interdependent cultures (conditioning?) taijin kyoufushou (TKS) – (Japan) preoccupation with doing something that will make others uncomfortable, such as strong body odor, blushing, sweating, penetrating gaze Schizophrenia Thought disorder Positive Symptoms (+) Interruption to normal thinking / reasoning processes, especially coupled with unexplainable auditory or visual experiences (the brain tries to fill in the gaps to make sense but the result does not reflect reality) incoherence, loose associations, paranoia, clang associations, hallucinations (esp. auditory), delusions of: grandeur, persecution, reference Negative Symptoms (-) loss of normal thought or behavior, catatonia, social withdrawal, inappropriate emotions/affect Schizophrenia Cultural differences Content of hallucinations and delusions Initial stressors Social support roles Suicide http://www.youtube.com/watch?v=8 o0tcZ4mru8&feature=related Micronesia & First Nations in Canada: 15-24 yr olds Japan: steady across ages, seppuku USA/Western Europe: 65+ Other cultural variations: method, attitude about consequences (ghost creation vs. honor vs. damnation) What causes a psychological disorder? Biology: neurotransmitter imbalances What causes a psychological disorder? Biology: genetic predispositions + stress Stress: Mental and physical condition that occurs when a person must adjust or adapt to the environment Autonomic NS arousal, release of cortisol, adrenaline, noradrenaline Long-term stress: Stomach pain, asthma, eczema, hives, migraine headaches, rheumatoid arthritis, high blood pressure, colitis, heart disease, sore muscles (neck, back), indigestion, constipation, chronic diarrhea, fatigue, insomnia, sexual dysfunction, trigger psychological symp. What causes a psychological disorder? Environment: history of abuse, trauma, modeling, experience, cultural thinking (guilt, shame) Non-western explanations: Ghosts, curses, imbalance in environment, inappropriate rituals, problem with social network Stigma 1 Labeling people with a condition 2 Stereotyping people with that condition 3 Creating a division – “us” and “them” 4 Discriminating against people based on their label What group of people is the most stigmatized in the United States? List your top 5 and agree on the number 1. Think of a positive and a negative media portrayal of that group. Stigmatization of Psychological Disorders Name implies it is different from physical illness Mind/brain distinction: Sounds as if it’s “all in one’s head” Blame: many people believe it results from poor choices Individualistic view: should have personal responsibility & control Objectives Describe the most studied culture bound psychological disorders. Identify the role that culture plays in the expressed symptoms and course of psychological disorders. Anxiety hikikomori – social withdrawal (Japan) living as a recluse, no contact with anyone dhat syndrome – (South & East Asia) preoccupied/anxious that they are leaking semen (semen viewed as a source of vitality, hard to make), often anxiety/guilt about masturbation bulimia nervosa – (Western) recurrent episodes of binging and inappropriate weight loss methods 3+ months, selfevaluation based on body weight Anxiety koro – (South Asian countries) fear that one’s penis is shrinking into their body frigophobia – (China) morbid fear of catching a cold susto – (Latin America) feel that soul is dislodging from their body voodoo death – (Africa) severe anxiety that someone has put a curse on them, leads to extreme behavior which often leads to death Anxiety Ghost sickness (Native American) weakness, bad dreams, feelings of danger, futility, suffocation, confusion, fainting, dizziness, loss of appetite Psychosis amok – (SE Asia, Malaysia) outburst of unrestrained violence with indiscriminate homicidal attacks, preceded by brooding and ending with exhaustion and amnesia, caused by stress, lack of sleep, + alcohol latah (SE Asia, Siberia, Japan) – transient dissociated state after a startling event with socially inappropriate behavior (barking, yelling sexual statements) followed by anmesia Psychosis arctic hysteria – (Inuit) hysterical attack with loss or disturbance of consciousness, resulting in tearing of clothes, rolling in the snow, speaking unknown languages Somatoform disorders malgri – physical symptoms (tired, sick, drowsy) after entering a new territory without performing the appropriate rituals agonies – (Portugal, Azoreans) burning, loss of breath, hysterical blindness, sleeping/eating disturbances brain fag syndrome – (West Africa, China) intellectual and visual impairment with burning sensation in head and neck, after too much mental work (brain exhaustion) Somatoform disorders ataques de nervios – (Puerto Rico) emotional events lead to palpitations, numbness, heat rising to head susto – (Central America) "soul loss" resulting from frightful or traumatic experiences – anorexia, diarrhea Treating Disorders Cleansing: the patient recounts the details of the frightening event, then lies down on the floor on the axis of a crucifix. The victim's body is then brushed with a bouquet of fresh herbs, while the curandero and other participants recite prayers. Depending on local custom, the curandero may also jump over the victim's body - this is thought by some to exhort the frightened soul back into the body Treating Disorders Vimbuza (Malawi): Chilopa- animal sacrifice Zar ritual: (Ethiopia) possessed person gathers with family and a priestess, animals and fruit are offered to the spirit and then eaten, the victim inhales cleansing scents and dances to drum music, the priestess becomes possessed with a spirit herself and makes peace with the possessing spirit – possessed person is instructed to keep peace with spirits (do their bidding) to avoid relapse Treating Disorders http://www.youtube.com/watch?v=fr WZx6iRQ9c 3:08-4:05 Healing circles Western: drugs, psychotherapy to change thinking or behavior, confront past experiences, interpersonal What is the long-term prognosis for treating a psychological disorder? http://www.youtube.com/watch?v=0 9kJdybTcvA until 2:36 Objectives Describe how culture influences physical health Describe the differences in cultural views of maintaining health and treating illness Physical Health What role does culture play in our overall physical health? Psychological process linked with physical health Genes, diet, medical care, attitudes stress Psychological process shaped and impacted by culture emotion Physical Health Modern medicine bound by scientific method, but reflects culture that produces the scientists, doctors, and patients. Different beliefs in cause of problems, lead to different treatment practices…beware of ethnocentrism! http://www.unnaturalcauses.org/video_clip s_detail.php?res_id=78 http://wn.com/native_american_healing_in _the_21st_century_richheapecom?upload_t ime=all_time&orderby=published