Part X: Culture and Mental Health

Part X: Culture and Mental Health

• A gunman killed 12 people at the Washington Navy Yard in Washington, DC on September 16, 2013.
• Aaron Alexis, the gunman, had a history of troubled behavior, including believing he was controlled by radio waves and being under surveillance.
• Alexis also exhibited signs of mental illness.
• Mental illness is not necessarily a cause of violence; individuals with mental illness are more likely to be victims than perpetrators.
• Early intervention and access to needed help could have prevented the tragedy.

Learning Objectives

• The chapter will define mental illness.
• It will differentiate symptoms from diagnosable disorders.
• It will identify the two primary methods for classifying mental illnesses globally.
• It will examine the historical evolution of mental illness classifications.
• It will define "culture-specific" or "culture-bound" disorders.
• It will provide examples of culture-bound syndromes.
• It will explain the concept of universal mental illnesses.
• It will outline the most common categories of mental illnesses globally.
• It will compare and contrast the symptoms of mental illnesses.
• It will identify and discuss common barriers to receiving mental health treatment in the United States and worldwide.

What is Mental Illness?

• A psychological disorder is characterized by abnormal thoughts, feelings, and behaviors.
• Psychopathology is the study of psychological disorders, including their causes and treatment.
• The criteria for determining abnormal thoughts, feelings, and behaviors should be agreed upon by mental health professionals.
• Abnormal behavior refers to beliefs and behaviors that suggest a psychological disorder.
• Behaviors like excessive hand-washing or hearing voices are examples of abnormal behavior, but everyday feelings like nervousness or homesickness aren't necessarily abnormal.

Making a Diagnosis (The 3 D's)

• Psychological disorders are defined as a psychological dysfunction that causes distress or impairment in functioning.
• Dysfunction involves disturbances in cognition, emotion, or behavior.
• Distress refers to the suffering or pain experienced by the person.
• Deviance relates to the violation of cultural norms or expectations.

History of Mental Illness

• References to mental illness have been found throughout history, but the understanding of mental illness and diagnosis has changed over time.
• Previously, mental illness was often attributed to supernatural causes but later theories focus on physiology and later on psychological factors.

Culture-Bound Disorders

• Culture-bound syndromes are combinations of psychiatric and somatic symptoms that are recognized as illnesses only within a specific culture.
• They are not related to physical, biochemical, or structural alterations.
• The Diagnostic and Statistical Manual of Mental Disorders (DSM) includes a list of common culture-bound conditions.
• Common characteristics of culture-bound disorders include being recognized as disorders in that particular culture, being widespread in that culture, and the lack of familiarity and understanding of the condition by people in other cultures.
• Some syndromes focus on somatic symptoms, while others are primarily behavioral.

Universal Disorders

• Universal disorders are mental illnesses that occur across various cultures and circumstances.
• Examples include Major Depressive Disorder (MDD), anxiety disorders, eating disorders, and psychosis.
• Mental illnesses often overlap between cultures, with shared symptoms and environmental triggers.

Major Depressive Disorder (MDD)

• MDD is characterized by a constellation of depressive symptoms, including depressed mood, loss of interest or pleasure, and several other symptoms that persist for at least two weeks.
• Cultural experiences can affect the presentation and treatment of MDD.
• MDD rates vary across cultures yet are relatively consistent across the globe, and people experiencing MDD frequently need treatment.

Anxiety Disorders

• Anxiety, in its various forms is a normal part of life and at normal levels supports daily functioning.
• Common types of anxiety disorders include generalized anxiety disorder, panic disorder, and phobias.
• Individuals with anxiety disorders experience symptoms like worry, tension, and physiological changes that are disproportionate and interfere with daily life.
• Anxiety disorders are often comorbid, meaning they frequently occur with other mental disorders such as depression.
• Cultural factors can influence the manifestation and experience of anxiety symptoms.

Eating Disorders

• Eating disorders are characterized by severe disturbances in eating behavior. These disorders can result in being normal weight or underweight, and are often linked to body image issues.
• Examples include Anorexia Nervosa and Bulimia Nervosa.
• There is a significant association between eating disorders and cultural values, particularly in Western cultures, which idealize thinness in women.

Psychosis

• Psychosis is characterized by a breakdown in the perception, emotional regulation, and thought processes of individuals.
• Hallucinations, delusions, disorganized thinking, and unusual motor behavior are common in psychosis.
• Schizophrenia is one form of psychosis which leads to impairments in daily life.
• Schizophrenia is highly variable with a wide presentation of symptoms across diverse cultures.
• The symptoms of schizophrenia often coincide during the transition from adolescence and adulthood which may cause further challenges.
• There is a perceived association of violence with psychosis but frequently other underlying issues like substance abuse co-occur.

Barriers to Treatment

• Mental disorders are widespread and costly.
• Many individuals experiencing mental illness do not receive treatment, due to various social and systemic factors, including cost, stigma, and cultural barriers.
• Mental health treatment is frequently not accessible and culturally insensitive around the globe leading to poorer outcomes for individuals.

Reducing Stigma around Mental Illness

• Negative attitudes and beliefs about mental illness can impede treatment outcomes, as sufferers may be wary or resistant to seeking help.
• Understanding cultural factors involved in mental health is critical in reducing stigma and promoting treatment.
• Awareness and education campaigns aimed at addressing negative stereotypes surrounding mental illness and helping to reduce related stigma are critical.

Chapter Review

• Psychological disorders are characterized by abnormal thoughts, feelings, and behaviors.
• Disorders are often the result from a combination of dysfunctional interactions between genetics, environment, culture and psychological context.
• The biopsychosocial model is a holistic view of mental illness, incorporating biological, psychological and sociocultural factors.

This quiz explores the relationship between culture and mental health, highlighting key concepts and definitions. Students will learn about diagnosing mental illnesses, including culture-bound syndromes and their historical classifications. Understanding these topics is essential for recognizing the influence of cultural contexts on mental health treatment.