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PSY321H1 (29)
Nick Rule (10)
Chapter 10

Textbook Ch.10: Mental and Physical Health

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Nick Rule

CHAPTER 10 MENTAL AND PHYSICAL HEALTH - hikikomori, unique Japan condition, loosely translates as social withdrawal Mental Health What Is a Psychological Disorder? - usually defined with respect to behaviours that are rare and cause some kind of impairment to the individual - dhat, disorder frequent in South Asian cultures characterized by a belief among young men that they are leaking semen - without the culturally shared beliefs regarding semen, sexual activity, and health that are prevalent among South Asians, dhat is meaningless to most North Americans Culture-Bound Syndromes Eating Disorders - 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 - 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 - 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 - bulimia nervosa, recurrent episodes of binge eating, inappropriate behaviours to prevent weight gain at least twice a week for 3 months - no documented cases in much of the world, particularly Africa and India - historical analyses reveal little evidence in past times Koro - 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 - (Earley-wine, 2001) some American men who had bad experiences while high on marijuana have reported koro-like symptoms - this and a number of rare incidents reported around the world suggests that some components are universally accessible Amok - 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 of anger - similar phenomena in Western cultures (i.e. mass killings); unclear if these similar behaviours are indicative of a common underlying disorder - frigophobia, primarily in China, a morbid fear of catching a cold leading people to dress themselves in heavy coats even in summer - susto, primarily in Latin America, 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, usually exhibit unusual behaviour - 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 - ataques de nervios, Puerto Rica, emotionally charged incidents 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 Universal Syndromes Depression - MDD 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 - cultural differences in whether people emphasize psychological or physiological symptoms - somatisation, symptoms primarily felt in body - psychologization, symptoms primarily in the mind - neurasthenia, a nervous syndrome commonly diagnosed among Americans in the 19 th century; no longer recognized in the DSM - (Kleinman, 1982) assessed 100 patients in China diagnosed with neurasthenia - 87% could be described as suffering from clinical depression but only 9% offered depressed mood as a chief complaint - somatisation is more common among Chinese presentation of depression, may be... - because of differences in the social stigma of having a mental illness - somatisation is pronounced even in private responses - because people from some cultures tend to focus on, and hence notice, certain symptoms more than people from other cultures - Westerners appear more sensitive o their own emotional experiences; Chinese psychiatric patients attend less to their emotional states - because symptoms are experienced differently across cultures - distinction between the mind and body more emphasized in Western thought Social Anxiety Disorder - the fear that one is in danger of acting in an inept and unacceptable manner, and that such poor performance will result in disastrous social circumstances - evidence that social anxiety concerns are more pronounced among East Asians; interdependence has been associated with heightened social anxiety - if it’s so common to be concerned about interpersonal relations, people may be less likely to view their anxieties as being impairing - less evidence of people who meet the criteria of social anxiety disorder in East Asia - taijin kyoufushou (TKS) identified in Japan as a phobia of confronting others - similar to social anxiety disorder but symptoms are very distinct - involves a number of physical symptoms, any of which are imaginary; extensive blushing, body odour, sweating, a penetrating gaze - “sever TSK” preoccupied with how uncomfortable others will feel around them because of their imagined repulsiveness - often most distressed around those of an intermediate degree of closeness - thus, social anxiety disorder is identified everywhere but in East Asian contexts, many symptoms are more common and manifestations of clinically problematic concerns varies Suicide - recognized similarly around the world; frequency varies greatly - virtually absent in Egypt and other Muslim cultures where religion is especially prohibitive toward suicide - differences in when people tend to commit suicide - USA, Hungary, Japan, increased among elderly; highest among 24 and younger in Egypt; consistently low in Micronesia - 1970s, Micronesia experienced a dramatic increase in suicides usually among adolescent males living at home, no outwards sign of psychological disorder, often sparked by arguments among peers of family about seemingly trivial matters, almost always by asphyxiation - highest rates limited to certain islands and suburban regions - suggests that these ritual behaviours have become part of the local culture - in Canada, suicide rates for First Nations adolescents is 5 times higher - possible factor is marginalization; First Nations youth can no longer identify with their traditional culture or with mainstream Canadian culture - studies found the more connections a community had with its traditional culture, the lower the community’s suicide rate - people’s motivation for suicide can vary considerably across culture - seppuku, suicide to accept responsibility and preserve one’s honour Schizophrenia - diagnosis requires at least 2 of the following symptoms present for a significant time during a 1 month period - delusions, hallucinations, disorganized speech, grossly disorganized or catatonic behaviour, negative symptoms - clear genetic factor (48% of development for identical twin), neuroanatomical differences - uniformity of symptoms, narrow range of prevalence across cultures - however, in the study, anyone who experienced different symptoms were excluded, and there was considerable variation in subtypes identified
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