Disorders of culture: the need to understand ‘why’ before you study.
My aim here is to highlight the need to take culture and social aspects into account when talking about and diagnosing disorders. It’s important that we do not study disorders blindly, without context. It could lead to misjudgements about causes and underlying problems
The rise in knowledge of and about many disorders has also increased the rise in non professionals taking an interest. This in turn has caused more problems of individuals faking disorders or they become ‘cool’ or interesting within groups of people. This has been discussed as the development of different versions of a disease. For example one of the well known groups of disorders this has happened in is eating disorders. They are specifically shaped by social and cultural development. Different causes cause a disease to be expressed in different ways, so when researching it is vital you know the social factors surrounding the disorder you are studying. The study of anorexia for example has identified many social and cultural risk factors, for example being female, in a place of rapid social change that is industrialised and democratic are all associated with a higher chance of getting the disease. As Katzman and Lee (1997) stated, with eating disorders becoming thinner is often not the objective, but what is critical is a fear of losing control of oneself. This manifests as a social problem, and a disorder of culture. In more industrialised countries there is more free choice this is often linked with more people feeling like they have less control, we are told we can be who we want to be, and do what we enjoy, for many this is a choice they would rather not have.
Another example of culture affecting psychological disorders has become apparent as we have been able to study the increasing development of Asian countries, particularly China and Japan. (Pike & Borovy, 2004). Japanese women were thought to be more protected culturally from disorders of eating by living in a stable, and family orientated country. They typically have lower levels of weight related health problems. However, Japanese women living in England and the US are at a greater risk of developing eating disorders. This clearly shows a cultural link. Back in Japan, since the 70’s, data shows increases in documented cases. (You have to take into account that a part of this will be due to having more doctors/psychologists to do the diagnosing, and the ability to out a name to disorders that were already occurring).
Other cultural factors that have a big influence are traditions and trends of a country. For an industrialised country Japan remains an outlier of how gender is separated within work. For other countries a more equal outlook has been embraced, this has been absent in Japan. A more traditional approach for women is accepted, where maturity comes with having children yourself: this message is passed down within families and school, where a 12 year curriculum of domestic education takes place (specified by the ministry of education). This development and focus on motherhood causes there to be no clear intermediate age between child and adult (our teenage years) making few ways other than motherhood a way to become a mature adult. This is not just a social ideal but a paradigm at the core of the country: for example, a divorced woman is not automatically allowed city funded housing, whereas a divorced mother is. This focus on motherhood and therefore the lack of adolescence was seen with less of the disorders we see in teenagers.
Although I focused here on Japan as an example: what I am trying to highlight is that a disorder we think we know can be incredibly differenent depending on the social and cultural situation of the person. When researching disorders we should never study a participant without this context, particularly with disorders that seem to descend from culture.
References
- http://www.counselling-directory.org.uk/blog/2011/01/06/mental-illness-is-becoming-a-trend-among-teenagers/
- Pike & Borovy (2004). The rise of eating disorders in Japan. Culture, Medicine and Psychiatry 28: 493–531, 2004. DOI: 10.1007/s11013-004-1066-6
- Katzman & Lee (1997). Beyond Body Image: The Integration of Feminist and Tran cultural Theories in the Understanding of Self Starvation. International Journal of Eating Disorders 22:385–394.
mdscurr 
Cultural differences do present a great difficulty for researchers trying to generate theories about behaviour, especially when examining Western and Eastern cultures. The core of Western culture (such as USA, France, UK) is individualistic, which places value on the self-sufficient behaviours of each individual within the society. This is diametrically opposed to the collectivism observed in Eastern societies (such as China, Japan), which places value upon the ability to cooperate and put the greater community before the individual.
Ratner & Lumei (2003) have outlined the ways in which this cultural issue presents difficulties when attempting to compare the two (in the same way comparing oranges to apples is difficult- both are fruit, but other than that…), not least the issue of translation, and the individualism of personal cultural psychology (for example, a person may be a self-made businessman born in an individualist culture, but still possess a community-oriented philanthropic outlook). They therefore suggest using back-translating techniques when creating qualitative measures (e.g. guided interviews) or quantitative (e.g. questionnaires) to ensure the essence of the research question is being correctly understood. Also suggested is that when conducting cross-cultural studies, individuals ARE assessed on an individual basis, to accurately ascertain what their cultural psychology is.
Research used:
Ratner, C. & Lumei, H. (2003). Theoretical and Methodological Problems in Cross–Cultural Psychology. Journal for the Theory of Social Behaviour, 33(1), 72. doi:10.1111/1468-5914.00206.
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Week 24 Homework for TA « theundergradpsychologist said this on March 22, 2012 at 11:29 pm |
i loved this blog! i find culture particularly interesting in terms of research. Although you have focused mainly on how these disorders can effect people differently in different cultures, it think it is also important to focus on the fact that disorders are actually classified differently in different cultures. The DSM-IV-TR is the most internationally used classification system, however, there are also other classification systems, e.g. the ICD (international classification of Diseases). There are many differences between classifications of different disorders between the two. For example, both bi-polar disorder and schizophrenia can be diagnosed from the symptoms including hallucinations and delusions. What if one manual puts more emphasis on this being schizophrenia than bi-polar and vice versa? people who have the same disorder could be classified differently depending on their manual used and therefore their culture.
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I agree very much with what you have said here. There can be many problems that occur with not enough consideration of different types of cultures. Indeed, several researchers over the years have had their studies labelled as “ethnocentric”; the innate belief that your personal ethnic group takes precedence over others and does not account for anything different. Difference should not be a problem unless it is seen to place people in other groups that are regarded as “not normal” (Eberhardt et al., 2006).
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