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PSYC14 - Lec 11 (near-verbatim).docx

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C14 11: Culture and Abnormal Psychology Date: Nov 28, 2012 Slide 2:  There are many models to define abnormal behavior Slide 3: What is abnormal behavior?  Consensus among professionals is that what makes behaviors abnormal are if these: o A) Cause ppl to suffer distress o B) Hinder daily functioning  Cultural relativism holds that culture must be used to determine normality of behaviors o Understanding of culture to determine what is/isn’t normal Slide 4: Psychiatry here and beyond  Field of psychiatry is mainly developed within Western culture  These provide bases for categories of diagnosis (ex: Diagnostic Manual of Mental Disorders/DSM) o When psychiatry defined by the West is applied to other cultures, there’s tendency of evaluating the psychopathologies of those cultures in terms of how well they fit with the categories developed in West  When applied to other cultures, tendency to try to fit them in these categories Slide 5: Universal vs. cultural  Sometimes, these categories may reflect true universal categories of mental illnesses  Categories can also reflect culturally-specific conceptualizations of mental disorders that aren’t as meaningful in other cultures o Diff cultures have diff ways of conceptualizing mental disorders; one culture may define a disorder that doesn’t necessarily happen in other cultures  Culturally-bound syndromes – disorders that appear to be significantly influenced by culture; symptoms of the disorder don’t cluster together or absent in other cultures o These syndromes appear less frequently in other cultures o The symptoms that characterize the disorder may be absent or not clustered together in the same way in other cultures Slide 6:  CULTURALLY BOUND SYNDROMES Slide 7: Eating disorders common among N.American college populations, especially among women  Name: Bulimia Nervosa  Alias: bn  Birth: 1770  Diagnosis: binge eat and purge, constant dissatisfaction with body shape and weight – stop from gaining weight from binge 1 C14 11: Culture and Abnormal Psychology Date: Nov 28, 2012 o Some of the things they do: self-induced vomiting, purging medicative vomiting, fasting and excessive exercising  Another symptom: their self-evaluations are unduly based on body shape and weight  Although bulimics have more realistic perception of their body; don’t have gross distortion of their body – consistently dissatisfied with their shapes/weight and concerned about losing weight  Trademark: common among women  Culturally bound in western culture Slide 8: Why cultural bound?  Culture can influence eating habits (direct and indirect) o What kinds of food we eat o The extent to which eating is emphasized in our daily lives in a culture o Culture can impact body weight issues  Culture can provide standards of beauty to idealize  In western societies, the thin frame has slowly become the ideal body image – presented by diff media Slide 9: Garner and Garfinkel  Compared dance and modeling students with female university music students  Former groups’ choice of careers typically focus on controlling body shape and weight  Expected that these groups would also show more instances of eating disorders Slide 10: Eating Attitudes Test  26-item questionnaire that evaluates abnormal eating attitudes  5-point Likert scale ranging from very often to never o Include:  ‘I become anxious b4 eating’  ‘I vomit after eating’ Slide 11: Garner and Garfinkel  Eating disorders and excessive concern with dieting were overrepresented in both the dance and modeling students  The pressure to be slim (because of career choice) increased the likelihood of developing eating disorder Slide 12: How about other cultures?  No preoccupation with becoming fat in participants in China, Hong Kong and India nor distorted body images  BN is absent in Africa and India and among those few reported cases, typically in cultures with Western influences (ex: Southeast and East Asia and Middle East) 2 C14 11: Culture and Abnormal Psychology Date: Nov 28, 2012 Slide 13: King and Bhugra (1989)  Field survey in an industrial town in North India of 580 school girls using EAT  29% showed abnormal eating behaviors based on EAT scores – surprisingly high 4 this culture  However, looking at some of the responses, 5 items were scored high in occurrence o Led to high scores and the idea that they may have bulimic attitudes o But if you break it down, the 5 items are below Slide 14:  Culturally desirable behaviors: o ‘cut my food into small pieces’ o ‘display self control around food’  Fasting concepts (Hindu religion): o ‘eat diet foods’ o ‘engaged in dieting behaviors’  Literal translation (the girls took it literally; in this society, food is scarce – common to value it): o ‘feels that food controls my life’  RESULTS: showed that eating disorder was low o The items above meant diff things for this culture; if the scores for these items removed & only scores for other items were used  eating disorder is actually low in this society Slide 15: Westernization Westernization may not be the only key variable  Modernization – industrialization, urbanization and health improvements – means:  High calorie food consumption, abandoning traditional food sources, technological improvements leading to less physical activity – easier increase in body weight  Migrating to Western (modernized) society can lead to developing eating disorder? Slide 16: Mumford and Whitehouse  Conducted survey among Asian and Caucasian school girls in Bradford, UK and school girls in Lahor, Pakistan  used EAT inventory  BN prevalence: o Asian school girls in Bradford > School girls in Pakistan & Caucasian school girls in Bradfr Slide 17: Another culturally-bound syndrome  Name: Running Amok  Alias: amok  Birth: 1770  Diagnosis: acute outburst of unrestrained violence (homicidal) preceded by brooding and ending with amnesia/exhaustion  Identified in several southeast cultures: Laos, phillipines, Malay = origin 3 C14 11: Culture and Abnormal Psychology Date: Nov 28, 2012  Triggered by stress, lack of sleep, alcohol consumption o But there is no clear motive for the actual fatal attack  Trademark: common among men Slide 18:  No clear motive to fatal attack o One hypothesis proposed: for rural Malay cultures – ppl expected to be passive and non-confrontational – so, to express frustration that has slowly built up inside and was unable to be released – because of social constraints – person explodes from anger  Traditional, Malay cultures are expected to be passive and non-confrontational o Attack isn’t pre-meditated or due to any religious reasons o Essential features =  Very sudden and there’s no warning symptoms prior to it  Would attack anyone in their way; aggression only when obstacle present – when there’s a person/object in the way  Patient doesn’t remember afterwards usually  Amok is an explosion of the unreleased anger  Key aspects are the suddenness of the attack and the absence of reason or warning symptoms  Gelap meta (Indonesia); huramentado (Philippines) – these are other names for same idea  This could be acceptable in these cultures without any prior causes but it could be that they have mental disorder – but then it wouldn’t be amok anymore Slide 19: Another Culturally bound syndrome  Name: Koro  Alias:  Birth: 221 BCE – 206 BCE  Diagnosis: acute panic anxiety due to belief that protruding reproductive organ is retracting into body with anxiety that this will result in death and they want to stop the retraction  Trademark: common among men  Prevalent in south-east Asian countries  Is in DSM4 as culturally bound syndrome Slide 20: Male Koro  Shrinking of the male genitalia can lead to erectile dysfunction, sterility and death  Reproductive ability determines person’s worth  Fear of death = primary ideation for anxiety in these males  First described in Chinese medicine textbooks as suo-yang involving excess of cold or defect in liver or kidney function or death – with genitals retracting  Traditional view of possession by a female fox spirit that causes disappearances – fox spirit needs to be driven out of the system 4 C14 11: Culture and Abnormal Psychology Date: Nov 28, 2012 Slide 21: Primary vs. Secondary Koro  Primary koro – individual or collective fear provoked by assumed threat to reproductive ability  Secondary koro – symptoms secondary to underlying mental or somatic disorder o Koro-like symptoms that are secondary to underlying mental or somatic disorder or drug-induced condition o Treatments really focus on these underlying disorders to take away koro symptoms o In Western societies, more koro symptoms = secondary  Mostly South East Asian cultures Slide 22: Female Koro  Shrinking/retraction of the breasts and external genitalia  Primary ideation in female koro was fear of breast damage The person experiencing koro attack believes it and perceives it – sees it happening and tries to stop it. Slide 23:  Name: Voodoo Death  Alias: psychogenic death and hax  Birth: 1942  Diagnosis: sudden, unexplained death from a voodoo curse o Person places a curse on another that they will die and common occurrence – the hex comes from witch doctor; other sources = taboos, breaking rituals within community  Trademark: state of fear; refusal of food and water Slide 24:  Observed in primitive societies in Central and South America, Africa, Australia and the Carib  Once cursed, person is doomed, terrified for the impending death  Refuses food and water in terror  Family and relatives prepare for person’s death Slide 25: Cannon (1957)  Emotional stress resulting from persistent state of fear or terror  Flight or fight in which powerful emotion of fear are associated with instinctual behavioral repertoirs; if rage present = instinct is to attack; if fear present – inst
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