Contribution To Sociocultural Science PDF

CONTRIBUTION TO SOCIOCULTURAL SCIENCE TRANSCULTURAL PSYCHIATRY Culture is defined as a set of meanings, norms, beliefs, values, and behavior patterns shared by a group of people. Include social relationships, language, nonverbal expression of thoughts and emotions, moral and religiou...

CONTRIBUTION TO SOCIOCULTURAL SCIENCE TRANSCULTURAL PSYCHIATRY Culture is defined as a set of meanings, norms, beliefs, values, and behavior patterns shared by a group of people. Include social relationships, language, nonverbal expression of thoughts and emotions, moral and religious beliefs, rituals, technology, and economic beliefs and practices, among other items. 6 ESSENTIAL COMPONENTS OF CULTURE (1) Culture is learned; (2) Passed on from one generation to the next; (3) Involves a set of meanings in which words, behaviors, events, and symbols have meanings agreed upon by the cultural group; (4) Acts as a template to shape and orient future behaviors and perspectives within and between generations, and to take account of novel situations encountered by the group; (5) In a constant state of change; (6) Patterns of both subjective and objective components of human behavior.  Race Human beings are grouped primarily by physiognomy Ethnicity Subjective sense of belonging to a group of people with a common national or regional origin and shared beliefs, values, and practices, including religion Part of every person's identity and self-image. PURPOSES OF CULTURAL FORMULATION (1) Enhance the application of diagnostic criteria in multicultural environments; (2) Cultural conceptualizations of distress; (3) Psychosocial stressors and cultural features of vulnerability and resilience; (4) Enable the clinician to systematically describe the patient's cultural and social reference groups and their relevance to clinical care; (5) Identify the effect that cultural differences may have on the relationship between the patient and family and the treating clinician, as well as how such cultural differences affect the course and the outcome of treatment provided FIVE AREAS OF ASSESSMENT (1) Cultural identity of the individual; (2) Cultural explanations of the individual's illness; (3) Cultural factors related to psychosocial environment and levels of functioning; (4) Cultural elements of the relationship between the individual and the clinician; (5) Overall cultural assessment for diagnosis and care. CULTURAL IDENTITY OF THE INDIVIDUAL Characteristics shared by a person's cultural group. Allows for a self-definition. Factors that comprise an individual's cultural identity include race, ethnicity, and country of origin, language use, religious beliefs, socioeconomic status, migration history, experience of acculturation, degree of affiliation with the individual's group of origin. CULTURAL EXPLANATIONS OF THE INDIVIDUAL'S ILLNESS The explanatory model of illness is the patient's understanding of and attempt to explain why he or she became ill.  COMMON EXPLANATORY MODELS OF ILLNESS Moral model implies that the patient's illness is caused by a moral defect such as selfishness or moral weakness. Religious model suggests that the patient is being punished for a religious failing or transgression. Magical or Supernatural explanatory model may involve attributions of sorcery or witchcraft as being the cause of the symptoms. Medical model attributes the patient's illness primarily to a biological etiology. Psychosocial model infers that overwhelming psychosocial stressors cause or are primary contributors to the illness. CULTURAL ELEMENTS OF THE RELATIONSHIP BETWEEN THE INDIVIDUAL AND THE CLINICIAN The cultural identity of the clinician and of the mental health team has an impact on patient care. The culture of the mental health care professional influences diagnosis and treatment. OVERALL CULTURAL ASSESSMENT FOR DIAGNOSIS AND CARE The treatment plan should include the use of culturally appropriate health care and social services. Interventions also may be focused on the family and social levels  MIGRATION, ACCULTURATION, AND ACCULTURATIVE STRESS From the time of the first major surge of immigration to the United States in the 1870s, and for the next 100 years, the predominant national sentiment toward immigrants, as in most other host countries, was that they should acculturate to the normative behaviors and values of the majority or mainstream culture of the host population.  The acceptance position encourages the cultural integration of immigrants, whereas the rejection position encourages either cultural exclusion or cultural assimilation. In order to assess the outcome of acculturative stress, for groups and their component individuals, two determining factors need to be considered. 1. The first is the extent to which the group and its members value and wish to preserve their cultural uniqueness, including the language, beliefs, values, and social behaviors that define the group. 1. The second factor is the mirror image issue of the extent to which the group and its members value and wish to increase their contact and involvement with other groups, particularly the majority culture.  FOUR POSSIBLE OUTCOMES Rejection is characterized by individuals' wishes, both conscious and intuitive, to maintain their cultural integrity Integration, as an outcome of acculturative stress, derives from the wish to both maintain a firm sense of one's cultural heritage and not abandon those values and behavioral characteristics that define the uniqueness of one's culture of origin.  FOUR POSSIBLE OUTCOMES Assimilation is the conscious and unconscious giving up of the unique characteristics of one's culture of origin in favor of the more or less complete incorporation of the values and behavioral characteristics of another cultural group. Marginalization is the psychological characteristics of rejection or the progressive loss of valuation of one's cultural heritage, while at the same time rejecting, or being alienated from, the defining values and behavioral norms of another cultural group. IMMIGRATION ACCULTURATION AND MENTAL HEALTH Many countries have had difficulty coping with the surging numbers of migrants. This has led to greater restrictions on migrant numbers, partly in response to public sentiment that the social and cultural integrity of the nation has become threatened, even undermined, by waves of migrants from other countries and cultures. RESEARCH IN TRANSCULTURAL PSYCHIATRY Based on identification of specific fields in general psychiatry that could be the subject of focused research from a cultural perspective. Topics of epidemiology and neurobiology could be assessed in this way. Address issues primarily in the public health arena, including stigmatization, racism, and the process of acculturation. Cultural variables should be considered in conducting cultural psychiatry research, including language, religion, traditions, beliefs, ethics, and gender orientation. RESEARCH IN TRANSCULTURAL PSYCHIATRY Only a few of the many cultural forms of expressing distress have received sustained research attention with integration of cultural and psychiatric research methods. Focuses on some of those syndromes from diverse cultural regions, which have received the most intensive research and have been shown to be associated with psychiatric categories. CULTURE-BOUND SYNDROMES AND THEIR RELATIONSHIP TO PSYCHIATRIC DIAGNOSES AMOK Amok is a dissociative episode that is characterized by a period of depression followed by an outburst of violent, aggressive, or homicidal behavior. Episodes tend to be caused by a perceived insult and are often accompanied by persecutory ideas, automation, amnesia, and exhaustion. Patients return to premorbid states following the episode. Amok seems to be prevalent only among males. Originated in Malaysia, but similar behavior patterns can be found in Laos, Philippines, Polynesia (cafard or cathard), Papua New Guinea, and Puerto Rico (mal de pelea), and among the Navajo (iich 'aa).  EPIDEMIOLOGY OF AMOK Epidemiological rates of amok in Malaysia and Indonesia are unknown. Essentially unknown in women (only one case was found in the literature, and it was considered atypical in that no deaths occurred). Occur more frequently in men of Malay extraction, Muslim religion, low education, and rural origin, who are between the ages of 20 and 45 years. Rates of relapse are unknown. It is considered very likely in the popular view, leading currently in Malaysia to permanent psychiatric hospitalization of surviving subjects, and, in the past, to banishment or execution. TREATMENT (AMOK) Afflicted individuals in 20t h-century Malaysia have been exempted from legal or moral responsibility for acts committed while in a state of amok by means of a kind of "insanity defense,“ Subsequently hospitalized, sometimes permanently, and frequently received diagnoses of schizophrenia and were treated with antipsychotic medication. Trials have sometimes resulted in criminal verdicts and prolonged imprisonment. ATAQUE DE NERVIOS An idiom of distress principally reported among Latinos from the Caribbean, but recognized among many Latin American and Latin Mediterranean groups. Commonly reported symptoms include uncontrollable shouting, attacks of crying, trembling, heat in the chest rising into the head, and verbal or physical aggression. Dissociative experiences, seizure-like or fainting episodes, and suicidal gestures are prominent in some attacks but absent in others. Syndrome indigenous to various Latin American cultures, notably those of the Hispanic Caribbean (Puerto Rico, Cuba, and the Dominican Republic).  PRECIPITANTS (ATAQUE DE NERVIOS) Linked by sufferers to an acute precipitating event or to the summation of many life episodes of suffering brought to a head by a trigger that overwhelmed the person's coping ability.  EPIDEMIOLOGY OF ATAQUE DE NERVIOS Risk factors for ataque de nervios span a range of social and demographic characteristics. The strongest predictors of ataque are female gender, lower formal education, and disrupted marital status (i.e., divorced, widowed, or separated). Less satisfaction in their social interactions generally and specifically with their spouses. TREATMENT OF ATAQUE DE NERVIOS Typical treatment involves, first, ensuring the safety of the person and those around him or her, given the association between ataque, suicidality, and uncontrolled aggressivity. "Talking the person down" is usually helpful, accompanied by expressions of support from relatives and other loved ones; the use of rubbing alcohol (alcoholado) to help calm the person is a culturally prescribed way of expressing this support.  POSSESSION SYNDROME Involuntary possession trance states are very common presentations of emotional distress around the world. Cognate experiences have been reported in extremely diverse cultural settings, including India, Sri Lanka, Hong Kong, China, Japan, Malaysia, Niger, Uganda, Southern Africa, Haiti, Puerto Rico, and Brazil, among others. Possession syndrome is an umbrella English language term used to describe South Asian presentations of involuntary possession trance that encompasses multiple names in regional languages and dialects of India and Sri Lanka. Seen as a form of illness by the person's cultural group because they are involuntary, they cause distress, and they do not occur as a normal part of a collective cultural or religious ritual or performance.  PRECIPITANTS (POSSESSION SYNDROME) Varied but typically consist of marked social or family conflicts, or stressful life transitions, of subacute duration, eliciting strong feelings of vulnerability in persons without firm emotional support.  EPIDEMIOLOGY (POSSESSION SYNDROME) More common in women, with a female-to-male ratio of approximately 3 to 1 in both community and psychiatric cohorts. Age of onset is usually between 15 and 3 5 years, but many cases reportedly begin in childhood. Constitutes a normative cultural category throughout India and Sri Lanka. It may present initially in a variety of forms, linked by the attribution of spirit etiology. TREATMENT (POSSESSION SYNDROME) Specialized indigenous practitioners and ritual therapies are generally available and widely utilized, but psychiatric treatment is typically avoided. Indigenous treatments include neutralization of the conflict or stress via the communal rituals involved in exorcism, as well as the reformulation of the suffering into beneficent individual and communal practice via initiation into a spirit devotion cult, such as the Siri cult of South India, or education into the roles of oracle (diviner), exorcist, or, rarely, avatar (divine incarnation). SHENJING SHUAIRUO ("weakness of the nervous system" in Mandarin Chinese) is a translation and cultural adaptation of the term "neurasthenia," which was transmitted into China from the West and from Japan in the 1920s and 1930s. Revived in its modern form by the American neurologist George Beard since 1868, his formulation of neurasthenia (Greek for "lack of nerve strength") originally denoted a heterogeneous syndrome of lassitude, pain, poor concentration, headache, irritability, dizziness, insomnia, and over 50 other symptoms. PRECIPITANTS (SHENJING SHUAIRUO) High rates of work-related stressors, which were made more intractable by the centrally directed nature of mainland Chinese society. Other interpersonal and family-related stressors included romantic disappointments, marital conflict, and the death of a spouse or other relative.  ADDITIONAL CLINICAL FEATURES Clinical course of the syndrome may depend on the associated psychiatric comorbidity and on the degree of persistence of the precipitating stressors.  SPECIFIC CULTURAL FACTORS The evolving definitions of shenjing shuairuo have emerged from a tradition of syncretism in Chinese medicine between indigenous illness understandings and international contributions.  TREATMENT (SHENJING SHUAIRUO) Most patients used both Western-trained physicians and traditional Chinese doctors. Nonpsychiatric medical settings were preferred, including neurology and general medicine clinics, in concert with cultural understandings of the somatopsychic etiology of shenjing shuairuo, which emphasize its physical mediation. The modality of treatment was usually traditional Chinese medicines, which were prescribed by both Western-trained and Chinese-style doctors. Polypharmacy was common, combining sedatives, traditional herbs, antianxiety agents, vitamins, and other tonics. Despite active suppression of religious healing in China, almost a quarter of patients were also engaged in such treatment. REFERENCE Synopsis of Psychiatry by Kaplan and Sadock 11th Edition pages 93-150 Contributions of the Psychosocial Sciences pages 93- 130 Contributions of the Sociocultural Sciences pages 131 -150 OTHER LEARNING RESOURCES You Tube Piaget's Theory of Cognitive Development - Simplest Explanation ever https://youtu.be/BxORL0nYcOc The Attachment Theory: How Childhood Affects Life https://youtu.be/WjOowWxOXCg Learning Theories https://youtu.be/B2bsyT2S82I Learning and memory https://youtu.be/Xkwl3k1Z03M Cultural influences on psychiatric diagnosis and treatment (nc) https://youtu.be/nmKeIN6tyKs