abnormal psychology discussion 800 words

For this discussion, you will enter into another conversation on an ongoing controversy and contemporary issue regarding abnormal psychology. Specifically, are there psychological syndromes and symptoms that appear only in certain cultures? I will provide as well samples of other discussionsAs you enter into this conversation, carefully consider the historical information you read regarding the discovery and identification of symptoms and syndromes that could potentially be bound to specific cultures. Then, take a moment to relate this historical background to the current ethical, clinical, and social considerations when working with individuals from diverse backgrounds. Interpret specific symptoms and syndromes as they relate to abnormal behavior from a culturally sensitive standpoint. Be sure to integrate knowledge of any appropriate cultural considerations psychologists must be aware of when working with individuals from backgrounds dissimilar to their own.Again, the goal of this discussion forum is to have a single dynamic and respectful conversation about culturally bound symptoms and syndromes, not a series of 20 to 30 separate conversations. This means every post should be in response to another post. Your instructor will be posting the initial thread to which you will respond. Only start a new discussion thread if you want to address an entirely different theme or question(s) within the discussion subject area. Additionally, only post after first carefully reading what all the others within the thread have written.A simple agree or disagree statement is insufficient to be counted as a response. When presenting your opinion, cite relevant sources (beyond your text) to support your statements. Do not repeat what your classmates have already written, and do not ignore them if they ask you questions. Any questions asked of you must be answered, including questions from your instructor. Try to keep the conversation moving forward by presenting options, insights, alternative ideas on and/or interpretations of the topics and research.You must post a response within the discussion on at least three separate days by Day 7, and your posts must total at least 800 words. There is no required word count for individual posts as long as your posts together total at least 800 words. There is no maximum number of posts for any discussion.Once your discussion is graded, your instructor will provide you with a summary of the week’s discussion and any conclusions or definitions that the class agreed on in your grading feedback. Please keep this summary in mind for future discussions in this course.http://www.apa.org/pi/oema/resources/policy/multicultural-guideline.pdf
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Example of discussions so far:
Controversy: Culturally Bound Syndromes and Symptoms
As I approach this conversation, I must say that I have no prior knowledge of the controversy
of culture-related syndromes and symptoms. Some of the syndromes or folk illnesses
highlighted in the article by Tseng (2006) are familiar to me; however, until now I never related
them to disorders or illnesses as documented in the DSM-5 or other manuals. With
consideration of the history of cultural psychiatry (as well as sociology and cultural
anthropology), current ethical, clinical, and social considerations should be applied gently, as
individuals from some backgrounds have formed their belief systems around specific, peculiar
phenomena. With that in mind, labeling, categorizing, and diagnosing some of these culturerelated specific syndromes and symptoms should be approached by understanding the
cultural implications of abnormal psychology, and providing treatments that are not only
socially appropriate for the people of multiple ethnicities and cultures, but which are also free
of common biases.
Take the phenomenon of amok from Malaysia, for example. Initially the war cry of Malay
pirates over 400 years ago, amok has transformed from a deliberate homicidal behavior into an
unconsciously driven mode of enraged mania accompanied by a dissociative state followed by
amnesia (Tseng, 2006). This is where we get the term “running amok,” for which the symptoms
of this formerly culturally-bound syndrome are parallel to psychiatric disorders involving
psychosis. However, this condition did not remain “bound” to Malays, as other observations of
amok behavior have been reported in New Guinea, Laos, Thailand, Philippines, and most
recently in schools and workplaces of the US (Tseng, 2006). This leads me to believe that
some culturally-bound syndromes and symptoms do not exist as conditions unique to one or
more specific cultures, and can manifest in individuals from any society, despite having not
been reported in more areas around the globe.
Another example that I found fascinating in the article by Tseng (2006) is the folk illness called
“koro,” (or suoyang in Chinese) that originated from Chinese ethnic backgrounds, and refers to
shrinking of the yang-organ (penis). Tseng (2006) explains that according to the literature, koro
epidemics had spread outside of China and into Singapore, Thailand, and India in the mid to
late 20th century. Other records have described koro epidemics in China during the 1800s.
Koro was defined by the socially-inflicted fear that the yang organ would diminish, thus
disturbing the balance of yin and yang as portrayed within Chinese culture and belief systems
(Tseng, 2006). Since the late 1980s, however, the presence of koro has diminished, and China
has experienced social changes that improved their economy and enhanced their quality of life
(Tseng, 2006). It seems that this socially-influenced phobia, if I may call it such, remained
within China and its bordering countries until the disorder diminished altogether, and it may be
important to document this culture-specific syndrome as a phobia that relates to genital
retraction. Although, since it appeared to be influenced primarily by social integration and was
mostly contained in homogenous Asian societies, perhaps culturally-bound syndromes and
symptoms do in fact exist.
Culturally Bound Syndromes and Symptoms Do Exist
On one side of this controversy, some researchers believe that there are culturally bound
syndromes and symptoms that manifest as a shared belief localized to a specific society or
culture. Regarding koro, the fear that genital retraction would ultimately lead to death,
researchers collectively support the sociological perspective that koro is nothing more than a
characteristic mode of sociocultural expression unique to homogenous Asian societies which
were not wholly exposed to other cultures before its observed demise (Marlowe, 2009).
Although some clinicians strongly believe that koro can be placed under a subgroup within the
DSM-5, others argue that koro is specifically culture-imposed, and does not reflect regularly
observed mental disorders. Therefore, classifying such a rare cultural e?ect as a disorder in
the DSM-5 would not be very clinically useful from a practical perspective (Tseng, 2006).
Reflection
Although I can agree with the perspective that some few disorders or problems (such as koro)
are culture-bound, I question whether enough research has been done to support this claim.
Even if a disorder is rarely documented, and is unique to specific cultures or societies, what if
epidemics of such disorders resurface in the future? No matter the severity of the symptoms,
ethically speaking we should consider any cultural and social implications and treat these
individuals who experience symptoms or syndromes that cause them distress, even if their
problems have arisen from folklore or popular myth.
Culturally Bound Syndromes and Symptoms Do Not Exist
On the other side of this controversy, there are culturally bound symptoms and syndromes that
present themselves with a strong likeness both to each other and to the disorders and
symptoms that are documented in the DSM-5 and ICD-10. There are documented
physiological and psychological similarities between kyol goeu (a Kmer fainting syndrome) and
ataque de nervios (a nervous attack previously described as Puerto Rican Syndrome), which
reflect anxiety symptoms in the DSM-5, with culturally-mediated presentations of the
symptoms (Tseng, 2006; Hsia & Barlow, 2001). Just as there are similarities between these two
phenomena, there are also commonalities among the presentations of ghost sickness, falling
out, brain fag, hwa-hyung, shenjing, shuiarou, shenkui, and shin-byung, all of which are bound
to di?erent cultures (Hsia & Barlow, 2001).
The argument is that given the evidence that many culture-specific syndromes and symptoms
overlap significantly, then we should look for the similarities while taking an informed approach
toward the underlying characteristics of each disorder’s cultural implications. In this way, we
can relate these disorders to those listed within the DSM-5 and ICD-10 and take a systematic
approach to diagnosing and treating these disorders while taking into account di?ering sociocultural beliefs and lifestyles. In psychiatry, it is always important to consider cultural diversity
and its implications before attempting to treat any individual. Take our final paper for example;
part of the integration technique within our psychological report includes documenting the
cultural background of our clients. Ethically speaking, considering any cultural and social
implications that relate to our patients can help us determine what method of treatment, if any,
is the most appropriate for their conditions.
Reflection
Considering what I have learned thus far, I can agree with relating existing culture-specific
syndromes and symptoms to those documented with the DSM-5 and ICD-10, and with
consideration of individual culture and beliefs, we can appropriate the best treatments if they
are available. However, given the few culture-specific syndromes or symptoms that have
diminished, such as koro, I feel that there are some conditions which are strictly culture-bound,
and are mediated by common social beliefs among specific cultures. Although, I also think
that more research should be done without making too many assumptions. The only problem
with my reasoning here is based on my own belief that if something happens once, it can
eventually happen again. Koro may come back to China and its neighboring countries, and it
may also re-manifest somewhere else from within a di?erent culture or society. Also, perhaps
we only define phenomena as exotic, atypical, or peculiar because they do not align with
systems that we have already put into place. Considering cultural diversity, individuals from
di?erent cultures show emotions, behaviors, and symptoms in di?erent ways due to social
learning, environmental influences, epigenetics, and personal traits. The same psychological
and physiological symptoms for a specific disorder may be happening among di?erent cultures
or ethnicities; the only problem that separates them is that their symptomatic presentations are
strongly mediated by cultural and social influences, as well as the traits unique to every
individual.
References
Hsia, C. Y., & Barlow, D. H. (2001). On the Nature of Culturally Bound Syndromes in the
Nosology of Mental Disorders. Transcultural Psychiatry, 38(4), 474-476.
Marlowe, K. (2009). The cultural myth of Koro conceptualization: Time for a rethink.
Transcultural Psychiatry, 46(2), 375-376. doi:10.1177/1363461509105830
Tseng, W.S. (2006). From Peculiar Psychiatric Disorders through Culture-bound Syndromes to
Culture-related Specific Syndromes. Transcultural Psychiatry, 43(4), 554-576. doi:
10.1177/1363461506070781
Reply Reply to Comment
COLLAPSE SUBDISCUSSION
Yolanda Harper
Yolanda Harper
Wednesday Nov 29 at 5:11pm
Manage Discussion Entry
Subject to Lauren and class: Results from the WHO-WPA and WHO-IUPsyS Global Surveys
Hello Lauren,
Excellent work on your post. Again, you’ve done a great job presenting more than one
viewpoint and incorporating scholarly, peer-reviewed sources. Your comment, “However, this
condition did not remain ‘bound’ …” raises another interesting topic. What are the mechanism
which “unbind” or “unleash” disorders, symptoms, or other /psychological phenomena across
cultures? What types of influences impact how disorders, symptoms, or other /psychological
phenomena, which may have been culturally bound to one or a small number of cultures in one
point in time, come to manifest in additional cultures? Your thoughts?
An interesting study
Robles et al. (2014) published a study (Links to an external site.)
Links to an external site.
in which they examined English- and Spanish-speaking psychologists’ and psychiatrists’
opinions regarding problematic, absent and stigmatizing diagnoses in current mental disorders
classifications (ICD-10 and DSM-IV). Note: While the DSM-5 was published in 2013, it often
takes several years for a study to get published in a good journal. So, I’m sure the DSM-5 had
not been released when they did their actual data collection. The researchers also asked the
respondents their opinions about the need for a national classification of mental disorders.
They were able to obtain 3,222 professionals from 35 countries to participate in their study.
Participants were asked the following four questions:
1
Are there diagnostic categories with which you are especially dissatisfied, or that
you believe are especially problematic in terms of their goodness of fit in clinical settings? (“If
yes, please explain”)
2
Are there any specific diagnostic categories that you feel should be added to the
classification system for mental disorders? (“If yes, please explain”)
3
Do you think that any of the terms used in current diagnostic systems are
stigmatizing in your language or cultural context? (“If yes, please explain”)
4
Do you see the need in your country for a national classification of mental
disorders (i.e., a country-specific classification that is not just a translation of ICD-10)? (“If yes,
please explain”)
The psychiatrists felt that the most problematic diagnostic group was
personality disorders due to poor validity and lack of specificity. The most frequent diagnosis
suggested for inclusion by psychologists was complex posttraumatic stress disorder.
Psychiatrists especially felt that schizophrenia was the most stigmatized disorder due to a lack
of understanding by the public.
As relates most specifically to our current discussion, 14.4% of participants perceived a need
for a national classification system, and of that group, two-thirds were from Africa or Latin
America. “The rationales provided were that mental disorders classifications should consider
cultural and socio-historical diversity in the expression of psychopathology, di?erences in the
perception of what is and is not pathological in di?erent nations, and the existence of culturebound syndromes (Robles et al., 2014, p. 165). Of course, a serious limitation of the study was
that the questions were only asked in English and Spanish. China, for example, which already
has the Chinese Classification of Mental Disorders, version 3 (CCMD-III) was not represented in
the study, except for Hong Kong, which was formerly a colony of the British Empire. Yet, even,
with this linguistic bias built into the study, the authors reported,
“A total of 324 (73.4%) of the participants provided specific explanations for their a?rmation of
the need for a national classification system. The main reasons were: 1) the classification needs
to consider cultural and socio-historical di?erences of societies (n = 194, 59.9%; e.g., “we have
a unique culture and experience, so we need our own classification system”, “nations and
cultures require diagnostic criteria that address the human in the context of culture”); 2) there is
a di?erent perception of what is and what is not pathological by country (n = 56, 17.3%; e.g.,
“in some societies it is considered normal to fear witchcraft”; “the presentation of psychotic
symptoms in a person may be viewed from a cultural perspective as a transition state to
becoming a ‘traditional healer”’); 3) the inclusion of an additional national diagnostic system
that would complement (rather than replace) current classifications (n = 56, 17.3%; e.g., “may
be some sort of complementary classification considering culture and language”; “perhaps
adding extra criteria – relevant to our society – that would aid in making diagnoses”); and 4) to
emphasize the national adaptation as a way to avoid using foreign classifications (n = 18,
5.6%; e.g., “it is di?cult to identify true etiologies when using foreign classifications”; “it is
better to describe the reality with your own language”). Significant professional di?erences
were found for two of the response categories: the third reason (national supplement for
general classifications) was more frequently reported by psychiatrists than psychologists
(21.2% vs. 10.7% respectively; ?2 (1) = 5.77, p = .01), while the fourth reason (national
adaptation to avoid using foreign classifications) was more frequently reported by
psychologists than psychiatrists (9.9% vs. 3.0%; ?2 (1) = 7.0, p = .008)” (p. 175).
Your thoughts?
Dr. Harper
Reference
Robles, R., Fresán, A., Evans, S. C., Lovell, A. M., Medina-Mora, M. E., Maj, M., &
Reed, G. M. (2014). Problematic, absent and stigmatizing diagnoses in
current mental disorders classifications: Results from the WHO-WPA and
WHO-IUPsyS Global Surveys. International Journal of Clinical and Health
Psychology, 14(3), 165-177. Retrieved from http://www.sciencedirect.com/science/article/pii/
S1697260014000088
Reply Reply to Comment
COLLAPSE SUBDISCUSSION
Lauren Brown
Lauren Brown
Yesterday Nov 30 at 2:58am
Manage Discussion Entry
Dr. Harper,
Thank you so much!! I couldn’t find any evidence to suggest the process by which we would
unbind somatic symptoms and disorders from specific cultures. But I would say that we might
start by determining whether a disorder was contained to one continent for a brief time (or
moments in time), and look at the way in which the disorder developed and manifested. If the
disorder was contained to one continent and its cultures (and even surrounding areas) for a
recorded allotment of time and was not reported in other continents, or more specifically, other
cultures, we could say that the disorder and its somatic symptoms are bound. I think a good
example of this is koro, which was a socially implemented form of anxiety with no real
physiological e?ect. So, with that premise in mind, in order to unbind a disorder from a
specific culture, a disorder must be evident within multiple cultural/ethnic groups, across
continents, and across time (as symptoms should evidently persist, instead of diminish as did
koro), regardless of it’s many names, social perceptions, and origin stories.
I think that there are now many influences which impact how disorders, symptoms, or other /
psychological phenomena (“which may have been culturally bound to one or a small number of
cultures in one point in time”) come to manifest in additional cultures. Some influences may be
the passage of old stories of these conditions by word of mouth, which can induce anxiety for
some individuals. In present day, media could influence once known cultures to resurface in
several ways, depending on the media source, its credibility on the history of the disorder, and
whether there are attached stigmas. Also, we know that reports of once known disorders do
exist, and anyone with the available technology can come across biased sources of information
and spread the idea of an illness or disorder by communicating its etiology to his or her society
or culture, thus causing a widespread epidemic of anxieties and abnormal behaviors–if that
makes sense.
Maybe I can put it another way…let’s go with koro, since I’ve developed a good understanding
of this disorder. Let’s say that koro is a legendary dandelion, that was indigenous ONLY to
China and its outskirts, involving India, Singapore, and other surrounding areas, of which each
area gave it a di?erent name. Now let’s say that this species of dandelion, the koro dandelion,
died out, as far as everyone knows. But then one day, A Westerner visiting China came across
a lone koro dandelion, was overwhelmed by its existence, and plucked it from the ground. The
Westerner returned home with the dandelion, and blew its seeds into the wind. Now that the
seeds have spread across a new land, so will the existence of the dandelion.
With both research and beliefs considered, I think the world might benefit from having country
or culture-specific classifications that don’t replace or discredit the DSM-5 and ICD-10, but
complement them instead. As you quoted in your response referenced to Robels et al., (2014),
“3) the inclusion of an additional national diagnostic system that would complement (rather
than replace) current classifications (n = 56, 17.3%; e.g., “may be some sort of complementary
classification considering culture and language”; “perhaps adding extra criteria – relevant to our
society – that would aid in making diagnoses”).” I think that if applied appropriately (which may
take some time), a complementary classification system proposed and accepted by WHO
which can be used in addition to the DSM-5 and ICD-10, may be very useful and practical in
clinical settings. I would even go so far as to suggest that a a new worldwide manual be
compiled which addresses known culture-specific disorders or disorders that are percieved by
multiplle cultures di?erently, with diagnositic criteria and treatments listed as well as if they
correspond to specific disorders within the DSM-5 and ICD-10. This would take extensive
research, documentation, and multiple revisions; but, I don’t think it’s an impossible notion.
Reference
Robles, R., Fresán, A., Evans, S. C., Lovell, A. M., Medina-Mora, M. E., Maj, M., & Reed, G. M.
(2014). Problematic, absent and stigmatizing diagnoses in current mental disorders
classifications: Results from the WHO-WPA and WHO-IUPsyS Global Surveys. International
Journal of Clinical and Health Psychology, 14(3), 165-177. Retrieved from
http://www.sciencedirect.com/science/article/pii/S1697260014000088 (Links to an external
site.)
Links to an external site.
Reply Reply to Comment
COLLAPSE SUBDISCUSSION
Francisco Kromer
Francisco Kromer
Yesterday Nov 30 at 4:51pm
Manage Discussion Entry
Hello class,
As I review the opposing sides of culturally bound syndromes and whether they exist or not, I
feel …
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