Considering the cultural context in psychopathology formulations

Abstract

ARTICLEIt has become apparent that psychiatric patients yearn for more than a diagnosis: they have a great need to appreciate their experiences from a cultural and social perspective.[1] Culture influences views and experiences during the course of one's life, which then have an influence on behaviour. Thus, persons of different cultures may articulate similar behavioural tendencies, but express them according to culturally sanctioned norms. [2] Of significance is a culture's capacity to modulate emotional regulation.[3] In traditional African cosmology, for example, the symbiosis between the seen and unseen is unquestionably acknowledged.[4] Numerous theories focused on the composition of emotion do not illustrate the African experience effectively.[5] To illustrate such experiences, there appears to be a need for thorough assessment of cultural views on psychopathology. However, the need to explore cultural conceptualisations of psychopathology is not new. Edgerton [6] researched psychopathology in the traditional African domain and requested that research explore the cultural domain so in order to inform academia. Edgerton's primary concern was that modern nosologies misrepresent the cultural and social veracity of authentic cultural experience. To reframe these views, it appears that, in some clinical contexts, a culture of misunderstanding psychopathology has been observed.In many ways cultures, relative to epochs and geographical contexts, determined the development of present-day psychopathology formulation. As such, the understanding of psychopathological symptoms has varied from place to place, time to time, and community to community. None of the formulations, however, appear to have received as much academic interest as the Western view of mental illness. Bhugra and Bhui [7] hold that the misdiagnoses of what they describe as Western-specific psychopathology may occur due to limited cultural awareness. This is particularly evident if one considers the body of knowledge signifying, for example, that auditory hallucinations are dependent on the pathoplastic influences of culture -that is, the ways in which psychological distress manifests. [7] Certainly, research into culture will help clinical formulation develop towards a more holistic approach. While there is currently an emphasis Background.Mental health research appears to be continually transforming. Recent literature reflects a greater appreciation for the ways in which pathoplastic features of culture modulate emotional regulation. This article introduces those aspects of the literature which explore the (re)consideration of culture as a dynamic and essential construct in the clinical formulation of psychopathology. Objectives. The study aims to review literature that focuses on the dynamic influence of culture in psychopathology. Furthermore, the researchers aim to present a view on the ways in which culture appeared to shape the topography of psychopathology nosology. Method. A literature review of 31 sources. Results. The review indicated th...

Culture and Borderline Personality Disorder in India

“…These include urbanization, forced migration, climate change, war, political violence, new information technologies, and social media, giving rise to new forms of identity. Hassim and Wagner (2013) have specifically identified how culture and religion as a socio-contextual determinant of psychopathology define the acceptability of affect, cognition, and connation (see Lohani et al, 2013). Dein and Dickens (1997) have cited an example of the Muslim view on suicide, which is forbidden in Islam but is honored in some Japanese communities.…”

“…750-754). Many researchers have emphasized that religion, spirituality, or moral standards are aspects of culture that may influence psychopathology (e.g., Crenshaw, 1991;Dein and Dickens, 1997;Iyer et al, 2008;Hassim and Wagner, 2013). Although in the case of BPD, it plays a less significant role.…”

Referral and collaboration between South African psychiatrists and religious or spiritual advisers: Views from some psychiatrists

“…A recent local study by Hassim and Wagner, [19] commented on by Rashed, [20] considered the cultural context in psychopathological formulation. It found that: health and behaviour are dependent, at least in part, on culture; psychopathology may also be understood as a social construct; culture has an influence on psychopathology, regardless of its aetiology; diagnostic classes do not adequately consider operational definitions; and a greater focus on hermeneutic perceptivity in appreciating cultural dynamics in psychopathology would benefit clinical assessment.…”

Measurement invariance of the Beck Depression Inventory-Second Edition across race with South African university students

“…Moreover, these findings are consistent with the established empirical evidence in South Africa, which shows that, while certain core symptoms of depression are encountered across the different cultures, it is also true that depressive symptomatology often has unique manifestations in some of these cultures as a result of social and cultural differences (Mosotho, Louw, Calitz, & Esterhuyse, 2008). According to Hassim and Wagner (2013) culture exerts pathogenic, psychoselective, psychoplastic, patho-elaborating, psychofacilitating, and psychoreactive effects to the experience of psychopathology. As such, culture modifies and modulates the expression and the structured manifestation of depressive symptoms in South African race groups (see Schlebusch, 2005).…”