Cultural Differences in Symptoms, Disorders, and Pathology

Cultures also differ as to what disorders are most typically observed, how symptom pictures are construed, and even what is considered pathological:

· Some disorders (e.g., schizophrenia and substance abuse) appear to be universal, although the exact content is culture specific. Hallucinations, for example, tend to contain familiar cultural material, such as voices speaking to the person in his or her native language or visions infused with cultural symbols and motifs. Other disorders (e.g., depression) can be observed across cultures, but they vary dramatically in relation to specific symptoms. In Western clients, for example, depression is diagnosed on the basis of a combination of psychological and physical symptoms, whereas among southeast Asian clients, physical symptoms such as headaches and fatigue are more prevalent indicators.

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· There are also culture-specific syndromes or disorders that appear only among members of a single cultural group. Jones and Korchin (1982) point to two—ataque, found only among Puerto Ricans, is a hysterical seizure reaction in which patients fall to the ground, scream, and flail their limbs. Largely unfamiliar to majority practitioners, it tends to be misdiagnosed as a more serious seizure disorder. A similar disorder, called “falling out” disease, is found only among rural southern African Americans and West Indian refugees and is regularly misdiagnosed as epilepsy or a transient psychotic episode.

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