Psychology Final: Crazy Like Us Flashcards

Questions and Answers

Cultures differ in their explanatory models for depression-like states. These models have the effect of ___

Directing the attention of individuals to certain feelings and symptoms and away from others

In some cultures, what we in the U.S. consider depression is viewed as a moral compass prompting individuals and culture to search for the source of the ___ that is causing the symptoms.

social, spiritual, or moral discord

The consensus paper GSK produced described that increasing suicide rates were an indicator of ___

Under-treated depression

The concept that most closely resembled modern notions of depression in Japan was utsusho, which was thought to reflect ___.

Stagnation of vital energy, or qi Signup and view all the answers

In Japan, utsusho was assumed the person would have to look for the ___ of his or her distress.

social or moral meaning Signup and view all the answers

_____ was introduced to the Japanese public as an illness of modernity during the industrial revolution.

Neurasthenia Signup and view all the answers

The illness communicated to the Japanese people in the early 1900s caused symptoms such as feeling that ______.

a heavy pot covered one's head Signup and view all the answers

After neurasthenia was introduced to the Japanese people, the diagnosis became somewhat trendy, and a brisk market in pills and potions sprang up.

Somewhat trendy Signup and view all the answers

During the industrial revolution, people who committed suicide as a protest against modernization were initially revered but later criticized as being ___.

weak-minded Signup and view all the answers

In the 1960s, the term ___ was introduced to Japan from Germany.

typus melancholicus Signup and view all the answers

The trait 'imported' from Germany into Japan mirrored a well-respected personality style prone to overwhelming ___.

sadness Signup and view all the answers

In Buddhism, sadness is discouraged.

False Signup and view all the answers

Japanese were less likely to accept a drug that ___, like antidepressants.

heightened moods or extraverted personality traits Signup and view all the answers

What was marketed as a 'cold of the soul' in Japan after the Kobe earthquake in 1995?

depression Signup and view all the answers

Without ____, the argument was that this cold of the soul could lead to one's death by suicide.

medical attention Signup and view all the answers

Lower levels of serotonin have been definitively demonstrated in depressed patients.

False Signup and view all the answers

Match the following terms with their descriptions:

SSRI = 5 out of 10 patients improve Placebo = 4 out of 5 patients improve Signup and view all the answers

What is associated with the increase in rates of anorexia and bulimia in China?

Cultural Cues Signup and view all the answers

The early cases of anorexia in China typically displayed a fear of fatness.

False Signup and view all the answers

What was the first formally called case of anorexia in the world?

Hysterical anorexia Signup and view all the answers

What type of illnesses are seen as examples of the unconscious mind expressing emotional distress?

Psychosomatic illnesses Signup and view all the answers

What term describes the back-to-back occurrences of anorexia after 1983 in the U.S. following a celebrity's death?

Symptom pool Signup and view all the answers

What surge in behaviors occurred in China after Princess Diana's interview in 1995?

Purging behaviors Signup and view all the answers

What aspect of Confucianism did Chinese doctor Sing Lee associate with early cases of anorexia?

Asceticism Signup and view all the answers

What was the name given to the condition of a 14-year-old girl who died from anorexia in China?

Yan Shi Zheng Signup and view all the answers

What phrase became popular in relation to the cause of anorexia among Chinese people?

Me too mentality Signup and view all the answers

What behavior is said to be exported instead of media beauty standards leading to food restriction?

Unconscious behavior Signup and view all the answers

What change occurred in the disease experience of anorexia after western influences spread in China?

Disease experience itself Signup and view all the answers

What behaviors may predispose individuals to adopt eating disorders as a means of managing distress?

Culturally sanctioned behaviors Signup and view all the answers

What are the three categories in which PTSD symptoms cluster?

Memory avoidance, uncontrollable anxiety, and hyperarousal Signup and view all the answers

Where did the diagnosis of PTSD originate during discussions?

With Vietnam War veterans Signup and view all the answers

What external factors contributed to PTSD in soldiers returning from Vietnam?

Military and society at large Signup and view all the answers

What did Debra Wentz educate the population in Sri Lanka about after the tsunami?

PTSD Signup and view all the answers

What is referred to as the method to help trauma victims retell or relive their experience?

Psychological first aid or Critical Incident debriefing Signup and view all the answers

The therapists who assisted after the tsunami were well-versed in Sri Lankan culture.

False Signup and view all the answers

What did children in Sri Lanka prioritize after the tsunami?

Returning to school Signup and view all the answers

What did reporters assess regarding the villagers' decision to leave refugee camps?

In denial Signup and view all the answers

What did mental health professionals compete for in Sri Lanka?

Refugee camps Signup and view all the answers

What medication was promoted for tsunami victims by Pfizer?

Zoloft Signup and view all the answers

What type of researchers arrived in Sri Lanka to assess PTSD rates?

Parachute researchers Signup and view all the answers

What subject were teachers being trained on with respect to PTSD?

Prevalence of PTSD Signup and view all the answers

What common misperception did survivors have regarding their participation in questionnaires?

Assistance for oneself or one's family Signup and view all the answers

What type of symptoms did Dr. Gaithri Fernando find were more common among Sri Lankans after trauma?

Physical symptoms Signup and view all the answers

What relational dynamics did Dr. Fernando observe in Sri Lankan trauma victims?

Social relationships Signup and view all the answers

What is the consequence of viewing trauma responses as solely individualized within cultural contexts?

Anxiety and depression Signup and view all the answers

What negative effect might critical incident debriefing have on the Sri Lankan victims?

Negative effects and increased symptoms Signup and view all the answers

What has contemporary western culture begun emphasizing instead of resilience?

Vulnerability Signup and view all the answers

Why do people diagnosed with schizophrenia in developing nations generally have a better prognosis?

Better prognosis Signup and view all the answers

What do Zanzibaris attribute to the cause of schizophrenia?

Spirit possessions and magical forces Signup and view all the answers

Delusions and hallucinations in schizophrenia are consistent across cultures.

False Signup and view all the answers

What triggers Hemed's psychotic episodes in Zanzibar?

Political strife or family stress Signup and view all the answers

What Islamic rule influenced Kimwana's behavior related to her schizophrenia?

Female modesty Signup and view all the answers

How did Amina's family respond to her mental health challenges?

The family was empathic and supportive Signup and view all the answers

What approach did Kimwana's family take towards her illness?

Allowed her to drift in and out of illness Signup and view all the answers

What family qualities correlate with high relapse rates in schizophrenia?

Criticism, hostility, and emotional over-involvement Signup and view all the answers

What is one of the central symptoms of schizophrenia identified by researchers?

Demanding, critical, or disparaging voices Signup and view all the answers

What are Zanzibaris' beliefs about enduring suffering in relation to faith?

Grateful for the opportunity to endure Signup and view all the answers

In Zanzibar, spirit possession is viewed as a common or extreme phenomenon.

False Signup and view all the answers

What is believed about spirits passed down from relatives in Zanzibar?

They have protective powers Signup and view all the answers

How does spirit possession affect the stigma around mental illness in Zanzibar?

Makes bizarre behavior more understandable Signup and view all the answers

The belief in spirit possession increases the blame felt by families of mentally ill individuals.

False Signup and view all the answers

What culture has been identified as having high levels of expressed emotion in context to mental illness?

Urban Anglo-Americans Signup and view all the answers

What is the internal attribution style associated with families that have high levels of expressed emotion toward mental illness?

Internal locus of control Signup and view all the answers

Why is mental illness often stigmatized in western cultures?

Due to the value placed on self-control Signup and view all the answers

What assumption may complicate the understanding of mental illness in western medicine?

Life choices/ weakness in character Signup and view all the answers

What concept did Dr. Lawrence Kirmayer research during the 2000 conference in Japan?

Culture Signup and view all the answers

Why did Eli Lilly choose not to market Prozac in Japan?

Believed the culture would not accept the drug Signup and view all the answers

What group does Japanese psychiatry primarily focus on?

Severely mentally ill Signup and view all the answers

What Japanese term referred to a rare and debilitating level of depression comparable to schizophrenia?

Utsubyô Signup and view all the answers

What approach did GSK consider to effectively market depression in Japan?

Market a disease Signup and view all the answers

What unique way did individuals from different cultures describe their feelings of depression?

A Nigerian man described a 'peppery' feeling in his head Signup and view all the answers

Study Notes

Anorexia and Bulimia in China

Dramatic rise in anorexia and bulimia rates in China over the past 15 years.
Cultural cues have been linked to the increase in eating disorders.

Early Cases of Anorexia in China

Early anorexia cases differed from Western norms.
Patients did not exhibit fear of fatness or misperception of body weight.

Historical Perspective on Anorexia

First recorded case of anorexia, termed "hysterical anorexia," emerged in 1873.
Primarily affected young women aged 15-20 who experienced emotional trauma.

Psychosomatic Illnesses

Connection made between officially recognizing anorexia and symptom presentation in women.
Edward Shorter's theory: psychosomatic illnesses are expressions of emotional distress tied to cultural context.

Resurgence After Media Attention

Anorexia cases increased following the death of singer Karen Carpenter in 1983.
Ethan Watters described it as a resurgence of the disorder in the Western symptom pool.

Bulimia and Cultural Influence

Princess Diana's 1995 interview sparked increased purging behaviors among Chinese adolescents.

Confucian Influence on Anorexia

Early cases of anorexia in China reflected Confucian values of asceticism, self-denial, and detachment from bodily concerns.

Emerging Terminology in China

After the death of a young girl from anorexia, authorities named the condition "Yan Shi Zheng" (dislike of eating disease).

Adoption of DSM Definitions

Chinese media adopted DSM explanations for anorexia symptoms, popularizing the "me too mentality."

Unconscious Behavior and Food Restriction

Emphasis on unconscious behavior as an influencing factor for food restriction behaviors in teenagers.

Changes in Disease Experience

Post media coverage, there was an increase in anorexia cases and a shift in the understanding of the disease experience.

Culturally Sanctioned Behaviors

Individuals with pre-existing mood disorders or trauma may adopt eating disorders as culturally sanctioned behaviors to cope with distress.

PTSD Symptoms

PTSD symptoms fall into three categories: memory avoidance, uncontrollable anxiety, and hyperarousal.

Origin of PTSD Diagnosis

PTSD emerged from discussions on the unique trauma experienced by Vietnam veterans, emphasizing the distinct nature of war-related trauma.

Impact of the 2004 Tsunami

The tsunami in Sri Lanka led to increased awareness and education on PTSD among survivors.

Critical Incident Debriefing

Western therapists advocate that individuals must retell traumatic experiences immediately to release trauma.

Cultural Considerations in Trauma Treatment

Lack of cultural understanding among therapists led to misconceptions about trauma reactions in Sri Lanka.

Psychological Needs Post-Tsunami

Many children in Sri Lanka prioritized returning to school after the tsunami, indicating a desire for normalcy.

Misinterpretation by Media

Western reporters perceived survivors' desire to return home as denial.

Competition Among Mental Health Professionals

Mental health groups competed for treatment opportunities in refugee camps following the tsunami.

Pharmaceutical Industry Influence

Drug companies promoted medications like Zoloft as essential treatments for tsunami victims in Sri Lanka.

Parachute Researchers

Trauma researchers flooded into Sri Lanka post-tsunami, creating confusion among survivors regarding their roles.

PTSD Studies and Misconceptions

Survivors mistakenly believed affirming PTSD symptoms on questionnaires would yield assistance for their families.

Cultural Differences in Trauma Response

Dr. Gaithri Fernando noted that Sri Lankans more often experienced physical symptoms in response to trauma.

Sri Lankan victims reported trauma impacts on social relationships rather than psychological states.

Western Culture and Trauma Understanding

A tendency to overlook cultural frameworks related to trauma responses can hinder understanding and support.

Negative Effects of Critical Incident Debriefing

Immediate re-exposure to trauma through debriefing may exacerbate anxiety and depression symptoms.

Vulnerability vs. Resilience

Contemporary Western culture emphasizes vulnerability rather than resilience in facing life's challenges.

Schizophrenia in Developing Nations

Research indicates that schizophrenia often has a better prognosis in developing nations compared to industrialized countries.

Cultural Beliefs About Schizophrenia

Zanzibaris historically attribute schizophrenia to spirit possessions and magical forces.

Variability in Symptoms Across Cultures

Delusions and hallucinations can vary in expression across cultures, with different cultural influences shaping these experiences.

Severity of Schizophrenia

Individuals with schizophrenia in developing nations experience less severe forms of the illness compared to those in developed countries.

Environmental Stressors and Mental Health

Stressors such as political conflict or family issues can trigger psychotic episodes.

Cultural Support in Mental Illness

Families in Zanzibar exhibit empathy and support for relatives with mental illnesses, reducing stigma.

Treatment Approaches in Zanzibar

Individuals with schizophrenia experience low pressure for self-identification as mentally ill, promoting a more normalized existence.

Family Dynamics and Relapse Rates

High expressed emotion in families correlates with increased relapse rates among individuals with schizophrenia.

Observations on Schizophrenia Voices

The experience of being critiqued and observed parallels the auditory hallucinations faced by individuals with schizophrenia.

Cultural Beliefs and Spirit Possession

In Zanzibar, spirits are not viewed as malevolent but can cause distress if not properly addressed.

Stigma and Shame Reduction

The belief in spirit possession helps lessen stigma and blame attached to mental illness within families.

High Levels of Expressed Emotion in the West

Urban Anglo-Americans exhibit the highest levels of expressed emotion, influencing mental health dynamics.

Locus of Control in Family Dynamics

Critical attitudes towards mentally ill family members indicate a strong internal locus of control among caregivers.

Western Views on Mental Illness

Western culture values self-control, leading to the stigmatization of those with mental illnesses viewed as lacking restraint.

Biomedical vs. Cultural Explanations of Mental Illness

The biomedical model implies that biologically-based illnesses carry a heavier stigma compared to those believed to result from lifestyle choices.

Collaboration with Pharmaceutical Companies

Pharmaceutical companies seek to understand the impact of culture on illness to effectively market treatments.

Cultural Feedback in Depression Treatment

Drug companies faced challenges in marketing antidepressants in Japan due to differing cultural perceptions of mental health.

Cultural Expressions of Depression

Different cultures describe depressive symptoms using varied metaphors, influencing the understanding and treatment of depression.

Moral Perspectives on Depression

In certain cultures, depression prompts moral reflection and a search for underlying societal or spiritual causes.

Awareness Campaigns by Pharmaceutical Companies

Campaigns aim to shift Japanese perceptions of social stressors and suicide as indicators of depression needing treatment.

Historical Japanese Conception of Health

Traditional Japanese health concepts interconnect health with moral, dietary, and behavioral considerations, linking health to cultural values.### Emotional and Social Context of Illness
Vital energy, known as qi, can become stagnant due to various factors including emotions, social conflict, loss, or physiological changes.
Utsusho, in Japan, was historically seen as a respected state of being rather than an illness; individuals sought social or moral meanings for their distress.

Historical Perspectives on Illness

Neurasthenia emerged in Japan during the industrial revolution in the early 1900s as a label for cultural anxiety.
Symptoms of neurasthenia included insomnia, concentration issues, tinnitus, stomach pain, and a feeling of pressure on the head.

Societal Trends and Responses

The diagnosis of neurasthenia became somewhat fashionable, with a surge in market offerings for cures post-introduction of the illness.
Initially, suicides protesting modernization were honored; however, psychiatry later characterized such acts as stemming from weak-mindedness.

Shifts in Understanding Mental Health

The early 20th century saw the decline of neurasthenia in Japan, only for typus melancholicus, a concept from Germany, to emerge in the 1960s.
This term resonated with Japanese values, reflecting seriousness and concern for others, but also prompted feelings of sadness amid cultural upheaval.

Cultural Views on Emotions

Buddhism promotes the acceptance of suffering over fleeting happiness; sadness is viewed as noble, while anger disrupts societal harmony.
As a result, the Japanese are less inclined to accept medications that enhance mood or promote extroverted behavior.

Impact of the Kobe Earthquake

Following the 1995 Kobe earthquake, the government's lack of response led to public interest in Western perspectives on depression, particularly through "Listening to Prozac."
Pharmaceutical companies likened depression to a "cold of the soul," attempting to redirect public perception from traditional concepts of utsubyô.

Marketing and Misconceptions

Marketing framed depression as manageable, but connections were drawn between untreated depression and potential suicide, with claims that 70-90% of suicides result from depression.
The narrative emphasized the necessity of medical intervention to prevent such tragic outcomes.

Scientific Skepticism

No conclusive evidence demonstrates lower serotonin levels in depressed individuals, suggesting the theory may be more culturally influenced than scientifically validated.
Research indicates that 50% of patients on SSRIs experience improvement, while 80% of those on placebo also report benefits, highlighting the complexities of treatment efficacy.

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Test your knowledge on key concepts from 'Crazy Like Us', focusing specifically on the cultural influences on eating disorders. These flashcards cover significant themes and insights that highlight the rise of anorexia and bulimia in different contexts, especially in China.