Chapter 12: mental health:
• hikikomori, unique Japan condition, loosely translates as social withdrawal. Usually involves Japanese high school students who
decide they don’t want to go to school perhaps because of bullying. Typically you just shut yourself in a room. They often take
out their frustration on their parents.
• often occurs if one is unable to meet the expectations set on him by parents, society etc. often the oldest son who has the carry the
• a number of sociocultural changes have been thought of as cause of the rise of this. These including the decreasing valuation of
work due to economic comfort of japan, the spread of more strike parents, and having job security and predictability due to the
structure of economy.
• Therapeutic intervention like rental sisters ( act as your sisters) to help you get out of the room.
• Only occurs in japan due to culture. The reaction of parents is different in japan ( they let him stay their). They belief a direct
approach (get into the room and break it down) will cause suicide. Some cultures have it BUT unique to JAPAN only. Thus
seems to suggest that culture is implicated in the expression and experience of psychopatholoy.
• Thus, the criteria for what is mental health abnormality vary across culture.
What Is a Psychological Disorder?
• Usually defined with respect to behaviors that are rare and cause some kind of impairment to the individual. But the what is
consider a problematic defers in every culture.
• dhat, disorder frequent in South Asian cultures characterized by a belief among young men that they are leaking semen and
semen in Asian culture is considered a source of vitality. So it makes them anxious since it is a high commodity whose lose is
• without the culturally shared beliefs regarding semen, sexual activity, and health that are prevalent among South Asians, dhat is
meaningless to most NorthAmericans
• One problem arises is why psychiatry is exposed to other cultures there is tendency to evaluate the psychopathologies that are
found in other culture in terms of how well they fit into those basic categories that were developed in the west ( i.e. DSM is
mostly made in the west)
• Some illnesses are universal but there are some that are not.
Culture bound syndromes:
• Culture bound syndrome: appear to be greatly influenced by the cultural factors. The above two are example of this as they
appear in specific culture.. To study them you have to consider the cultural value and understanding that go along with them.
• More common in the college student in NA.
• Bulimia nervosa: eat a lot then vomit very common in NA females college students. To be diagnosed with it one must
experience reoccurring bing eating episodes, , a lot with reoccurring behavior to keep off the weight ( i.e. vomiting). This must
happen twice a week for 3 months. Also have ones self-evaluation be unduly influenced by one body and not be diagnosed by
• No documented cases in much of the world, particularlyAfrica and India
• Historical analyses reveal little evidence in past times
• Anorexia nervosa, refusal to maintain a normal body weight, intense fear of gaining weight, denial of the seriousness of one’s
low body weight, miss 3 consecutive menstrual cycles.
• Seems to increase in culture as more and more of the cultural messages that attrack bodies are thin ones.
• Seem to appear in places where there is more western influence.
• Many studies fail to find cases in some cultures (Pakistan, Chinese)
• Other studies have found clear evidence in diverse cultural contexts with relatively little Western Influence (i.e. Caribbean’s and
• In some cases like in Hong Kong they are diagnosed but don't have any fear of fatness ( which is key in the west)
• Historical literature found many instances, “holy anorexia” .
• Seems to have many symptoms that are universal though they are still influenced a great deal by culture ( one is holy while other
is about the fat gain)
• Identified in a variety of South and East Asian countries
• Common among men, manifests as a morbid fear that one’s penis is shrinking into one’s body
• less common among women, manifests as a fear that one’s nipples are shrinking into one’s body
• 1967, epidemic in Singapore. Some American men who had bad experiences while high on marijuana have reported koro-like
symptom • This and a number of rare incidents reported around the world suggests that some components are universally accessible but
mostly clinical symptoms are within certain cultures.
• Identified in a number of Southeast Asian cultures
• An acute outburst of unrestrained violence, associated with (indiscriminate) homicidal attacks, preceded by a period of brooding
and ending with exhaustion and amnesia”
• -Thought to be instigated by stress, lack of sleep, and alcohol consumption
• -Theory that in Malay culture, there are cultural traditions to be passive and non-confrontational
• Suggests that some are unable to find culturally sanctioned means to express their frustration and explode in an uncontrolled fit
• Most of these people end up dead or diagnosed with some other disorders.
• Similar phenomena in Western cultures (i.e. mass killings but are pre-mediated); unclear if these similar behaviors are indicative
of a common underlying disorder
• Hysteria: historically in Europe, woman will be seem fainting insomnia, sudden paralysis, temporary blindness, loss of appetite
for food or sex and a general tendency to cause trouble. “ also called the “ the great neurosis”.
• Perhaps this was a repressive social norm of the Victorian times. With doing this they receive attention.
• Today this does not exist rather they are diagnosed with other disorder that is in the DSM.
• Thus this is an example of pathology that appear to vary in prevalence across culture and times.
Other culture bound disorders:
• frigophobia, primarily in China, a morbid fear of catching a cold leading people to dress themselves in heavy coats even in
• susto, primarily in LatinAmerica, people feel a frightening experience has caused their souls to be dislodged from their bodies
• voodoo death, primarily n Africa, people are convinced that a curse has been placed on them or they have broken a taboo
resulting in a severe fear reaction that sometimes leads to their own deaths
• latah, South Asian cultures, Siberia,Ainu in Japan, falling into a transient dissociated state after some kind of startling event such
as seeing a snake or being tickled, usually exhibit unusual behaviour ( barking like a dog, saying sexual statement,). The person
has no memory of these later onl.
• malgri, Australian aboriginals, when entering the sea or a new territory without engaging in appropriate ceremonial procedures,
thought to be invaded by a totemic spirit causing them o grow physically sick, tired, and drowsy
• agonias, Portuguese, anxiety disorder with a wide array of symptoms including a burning sensation, loss of breath, hysterical
blindness, sleeping and eating disorders
• brain fag syndrome, students in West Africa and China, associated with complaints of intellectual and visual impairment and a
burning sensation in the head and neck . often when stydying for exam. They complain their brains are dead and can no longer
• ataques de nervios, Puerto Rica, emotionally charged incidents (funeral or family conflicts) bring on symptoms like palpitations,
numbness, and a sense of heat rising to the head
• arctic hysteria, Inuit, hysterical attack in which patients experience a sudden loss or disturbance of consciousness leading them
to tear off their clothes, roll around in the snow, and speak unknown languages
• these symptoms do not match to anything in the West.
Universal Syndromes: 1) Depression
• MDD (major depression disorder in DSM-IV, show 5 of 9, including at least one of the first 2, for 2 weeks or more a) depressed
mood; (b) inability to feel pleasure; (c) change in weight or appetite; (d) psychomotor change; (f) fatigue or loss of energy; (g)
feelings of worthlessness or guilt; (h) poor concentration or indecisiveness; (i) suicidality
• International studies have found cases that fit the DSM-IV definition of MDD in almost every culture explored but we have to
keep in mind the variability. For example their are very few cases of depression in China and a lot of cases of depression in
Nigeria ( 4* more then US).
• Likewise bipolar disorder:similar to depression but often get manic episodes where they feel amazing and awesome. It seems to
be highest in English speaking like the US and low in east Asian ( non-English)
• The question of universality is furthure complicated as not all depressed people report the ame type of symptoms. Some have flat
response while other like Chinese have exaggerated response. Some