Cultural Psychiatry: Research Strategies and Future Directions

Abstract

This chapter reviews some key aspects of current research in cultural psychiatry and explores future prospects. The first section discusses the multiple meanings of culture in the contemporary world and their relevance for understanding mental health and illness. The next section considers methodological strategies for unpacking the concept of culture and studying the impact of cultural variables, processes and contexts. Multiple methods are needed to address the many different components or dimensions of cultural identity and experience that constitute local worlds, ways of life or systems of knowledge. Quantitative and observational methods of clinical epidemiology and experimental science as well as qualitative ethnographic methods are needed to capture crucial aspects of culture as systems of meaning and practice. Emerging issues in cultural psychiatric research include: cultural variations in illness experience and expression; the situated nature of cognition and emotion; cultural configurations of self and personhood; concepts of mental disorder and mental health literacy; and the prospect of ecosocial models of health and culturally based interventions. The conclusion considers the implications of the emerging perspectives from cultural neuroscience for psychiatric theory and practice.

Culture and Hallucinations: Overview and Future Directions

“…In a recent review of research strategies and future directions in cultural psychiatry, Kirmayer and Ben 54 warn against the danger of reifying culture and of relying exclusively on population-level categories of nationality or ethnicity in understanding its relationship to mental ill health. We also insist that culture cannot be reduced to national or even ethnic differences and that there are complex and significant variations within cultures—religious, regional, and political.…”

Interdisciplinary Approaches to the Phenomenology of Auditory Verbal Hallucinations

“…Anthropological studies of psychosis and schizophrenia have challenged the view that culture is of minor relevance to understanding AVH, 13–16 showing that “local theory of mind—the features of perception, intention, and inference that the community treats as important—and local practices of mental cultivation will affect both the kinds of unusual sensory experiences that individuals report and the frequency of those experiences.” 17 If the complexity of the relationship between culture and hallucinatory experience is to be adequately theorized and empirically investigated, researchers must make use of tools and disciplinary approaches which do not simply reduce “culture” to a one-dimensional variable (for which country of residence frequently functions as a proxy). Instead, as cultural psychiatrists and others 18,19 have argued, ethnographic and qualitative approaches have a vital role to play in investigating the ways in which communities interpret, legitimize, support, and even produce different voice-hearing experiences.…”

Cultural inroads in DSM-5

“…These circumstances, however, explain only in part the limited utilization of and meager research conducted on the DSM‐IV cultural components. Very few academic or training centers, mainly in Canada, the U.S. and Europe, faced up to the tasks of exploring the feasibility, usefulness and practical applicability of the OCF or the nosological validity of the CBS . Soon, criticisms about the ontological and practical unfitness of ethnographic approaches (the five narrative areas of the OCF) in the fluid, time‐limited course of diagnostic interviews in different clinical settings, started to appear.…”