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Mental Disorders: Culture-Bound Disorders

Cultural differences have an impact on mental health across the world. Although human physiology is essentially the same across all cultures, there are also many apparent differences in the ways that psychological disorders are manifested across cultural settings. There are many culture-bound disorders that are uniquely linked to certain groupd, however, there are also culturally universal disorders and approaches to treating mental health disorders.

A psychological disorder can be quite difficult to define as certain behaviours appear as a disorder among some cultures but do not in other cultures, for example - Western categories of mental illness may not reflect universal categories of mental illness. Disorders that are greatly influenced by culture either do not occur in other cultures or are manifested in different ways. Eating disorders such as bulimia and anorexia are considered somewhat universal, although bulimia is more culture-bound. These disorders are however rising globally due to changing cultural standards, making individuals feeling pressured to conform.

A more historical culture-bound disorder example would include hysteria. This disorder was diagnosed in the mid 19th century, associated with Freud's psychoanalytic theory. Symptoms included fainting, temporary blindness, a general tendency to cause trouble, insomnia, and/or sudden paralysis. Hysteria is not in the current DSM as some of the symptoms are now associated with other disorders. Amok is another example of a culture-bound disorder. It is associated with extreme homicidal violence, preceded by brooding and afterward rage, exhaustion, and amnesia. It is often correlated with alcohol consumption, lack of sleep, and perhaps the overarching passive culture that gives few outlets to aggression (i.e. Southeast Asian Cultures).

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Living in Multicultural Worlds

Acculturation is the process by which people migrate to and learn a culture that is different from their original (or heritage) culture. There are few commonalities that occur for all aculturating individuals and there are often challenges to identify common patterns. For example, moving to a new culture involves psychological adjustment - acquiring a new language, learning new interpersonal social behaviors, becoming accustomened to new values, often becoming a memory of a minority group, and adjusting one's 'self-concept'. Changes in attitude toward the host culture are essential and also a common pattern of adjustment to acculturation. In the first few months, people have very positive feelings about the host culture, but over time, negative feelings may overcompensate and are associated with culture shock. My family has hosted highschool aged international students for the past 5-6 years, and we have definitely noticed similar patterns among every single student that has lived with us - there are always up and downs.

These examples are clearly not easy challenges to take on, and are often associated with many downfalls of acculturation. The success of people's acculturation experiences seem to be influenced by the homogeneity of the society to which they are trying to acculturate - the greater the cultural fit, the more easily they will adjust to it. Changes in lifestyle that come with acculturation are often all associated with a variety of health outcomes (i.e. American culture and weight gain) - Japanese who acculturated to U.S. lifetyle often have an increased risk for heart disease. Other disadvantages of acculturation may include active discrimination, unjust treatment, mocking, humiliation, violence, etc. Clearly there are many factors associated with acculturation, making it very difficult to study its complexity.

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Physical Health Across Cultures

Even though human physiology is essentially the same across the majority of different cultures of the world, there are some noticeable differences in the process of how illness is delivered and appears in different cultural settings. This is influenced by the biological variability of humans - humans in various parts of the world were subject to different selection pressures over generations, resulting in the human genome diverging acrossing different populations. And also people people living in diverse locations have experiences within their lifetimes that have an impact on their biology.

Every person in the world is genetically unique, however, often these individuals do have more genetic variants in common with other people (i.e. shared ancestral origins). Humans evolve and develop in response to to environmental factors - therefore, specific traits are often specific to particular cultures and differ in others (for example, skin color represents genetic variability due to the body's ability to synthesize vitamin D).

There are also genetic adaptations to local climate, altitude, and pathogens - genomes that are influenced by geographical factors. For example, when I visited Peru, it was very difficult for me to adapt to the severe levels of altitude. The 4,000 m of elevation was a drastic difference in comparison to Nova Scotia's maxium elavation of 500 m - resulting in altitude sickness. However, the altitude does not affect Peruvians because their genomes are altered by these geographical factors.

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Sleep Patterns

Sleep is an absolute necessity amongst the human population. Not only does it provide physical rest, it is also quite important for physiological repair, consolidating of memories, and clearing products of metabolism from the brain. Despite awcknowledging its overall importance, sleep is often a topic that I would not typically associate with much cultural variation as I assumed the majority of the human population follow similar sleep patterns. However, it was interesting to discover while reading the textbook (chapter 14) the clear cross-cultural differences in sleep habits worldwide.

One aspect that stood out the most to me was how in some cultures, children co-sleep in the same bed as their parents, whereas in others, it is more common for children to sleep separately. This apparently can play a major role in child development as co-sleeping may eliminate the childs ability to self sooth, however, it can also create a stronger parent-child bond. There is also evidence found in cultures where children co-sleep with their parents that when the child grows up, their education is a matter that is decided by the family and marriages are often arranged by the parents. Alternatively, sleeping separately may aid in developing the child's independence as well as learning how to individually self-sooth before falling asleep.

It is interesting that such an action may result in such long-term outcomes. I personally did not co-sleep with my parents as a child and I would describe myself to be a very independent individual. I've also rarely experienced difficulty falling alseep throughout my life time, which I could potentially be associated with the technique of self-soothing I may have learnt as a child.

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Independent and Interdependent Views of Self

Research suggests that there are two basic ways people view themselves: independentally and interdepentally. The independent self derives their identity from their inner attributes (the basis of the individual's identity). These internal attributes of an independent individual grounds their overall identity. Furthermore, they're perceived to be unique and self-contained, rather than being influenced by the interactions of others. Individuals with an independent self-concept feel much closer to ingroup rather than outgroup members, therefore, interacting with other similar independent people.

The interdependent view of self is when the individual is a relational entity who is fundamentally connected to and sustained by a number of important relationships. This model represents the concept of self-identity by being defined by different social relationships, roles, and behaviors that are influenced by the perceptions of others thoughts, actions, and feelings. Therefore, these type of individuals are not viewed as seprate and distinct entities but rather as individuals part of a larger social group.

Based on these descriptions, I would perceive myself as having an independent view of self. I respectively appreciate the feedback and knowledge from others, however, it is important not to stricly rely on others. By being independent, I am able to encourage a strong sense of self-esteem and confidence and am able to tackle obstacles by myself.

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Choices in Life

One of the most important ways a person can exercise control over their world is by making choices. The choices we make throughout the course of our lifetime influence the way we grow and shape us into the individual person we are to this day. Some of the most important choices we make in our life include deciding who to marry, what job to have, where to live, having kids, and much more. The severity of choices ranges dramatically and it is rare to spend an entire day without having to make a choice - less important choices can include deciding what to have for dinner or what time to set an alarm for in the morning, etc. Overall, the choices we make structure our lives to match our desires and needs and are considered the most direct way we as humans engage in primary control strategies. 

Making choices freely is a way of life that is valued in many cultures worldwide. However, the extent to which people value choice and exercise it is influenced by context (i.e. their lifestyle, environment, and culture). For example, as I previously mentioned, choices such as deciding who to marry, where to live, and having kids is not a free choice in some cultures. Often it is the family in which you belong to that decides these milestones for the individual and is an examples of how culture can impact the choices a person make. 

I live in a very individualistic Canadian society since we are less dependent on the actions of others. However, people in collectivistic societies should (on average) be more concerned with the goals of their groups and be more willing to adjust their behaviours and reduce their choices to coordinate with the actions of the groups towards a certain goal. Personally, being raised in an individualistic society I recognize the importance of autonomy in contrast to the influences and desires of others. However, I greatly acknowledge the significance of not relying on other people to get by in life and how being an independent individual encourages a sense of having control over your life by promoting confidence, self-esteem, as well as motivating yourself to accomplish certain tasks.

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Motivation for Self-Enhancement

Research reveals that people apparently have a strong need to view themselves positively, otherwise known as self-esteem - the positivity of your overall evaluation for yourself. A self-serving bias refers to the tendency for people to exaggerate their positive characteristics. There has been plenty of experiments and conducted research proving this type of bias and has been observed in elementary school children, high school students, college students, and working adults.

Reflecting on my own self-esteem, I would evaluate myself lower on the scale. I do not believe I possess a self-serving bias, as I do not tend to exagerate any of my positive characteristics. However, it is difficult to measure self-assessments because there is no evidence to prove an individual is not above average (while referring to particular characteristics). People who are highly motivated to obtain a positive self-view are usually knowledgeable enough and determined to do so. This can also be done through upward social comparison (comparing your personal performance with someone else who is doing significantly better than yourself) as well as compensatory self-enhancement (accepting the fact you did poorly on something but acknowledging that your are good at other things). Therefore, as individuals, we have adapted ways to protect and encourage our self-perception, resulting in the majority of people having an overall high self-esteem.

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Who Am I?

Such a simple yet significant question we may individually ask ourselves on a regular basis through different forms of expression. This relevant question addresses the self-concept of individual identity and influences the way we act within society and perceive the overall world we live in. The “Who Am I?” exercise is an established measure of the self-concept called the “Twenty-Statements Test”. This test consists of stating 20 facts that best describe who you are and how you perceive yourself as an individual within this society. It is found that the words and categories you use to describe yourself can shed some light on the influence of your cultural background on who you are today and indicates a specific kind of understanding about the self. This simple exercise demonstrates how people all over the world (across different cultures) think of themselves in terms of both abstract psychological attributes and concrete roles and relationships. 

After personally completing this exercise, it definitely required me to heavily reflect on myself and my role within society. At first, I was very tentative and felt that I was being overly self-centered. However, as I continued to fill in my twenty statements, my confidence grew as I realized this exercise is simply for nobody but myself and my personal wellbeing. I perceived a sense of enlightenment as I thought about personal traits and felt more positive towards myself compared to how I originally felt prior to the Twenty-Statements test. This exercise definitely made my reflect on myself and my cultural upbringing.

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Is the mind independent of culture?

Psychology may assume that the mind operates under a set of natural, universal laws that are independent of content or context. We assume people are the same everywhere we go - however, this might not exactly be the case. Many psychologists believe that the mind operates similarly to a computer that operates without thinking about the content it is thinking about or the context within which they are thinking. However, cultural psychologists disagree with this statement - they believe that the way people think is influenced by the specific ways cultural knowledge shapes their understanding of those behaviors. For example, when we experience an event in our lifetime, this may shape how the brain responds to simple tasks - also known as brain plasticity (the brain’s ability to change and adapt as a result of experiences). We are especially susceptible to brain plasticity during childhood, as the brain has not fully developed at a young age. Many cultures differ from each other in drastic ways, such as beliefs, values, institutions, practices, and much more. Being part of a particular culture can, therefore, influence a person’s thoughts, actions, feelings, and overall, the way we think and perceive life - despite all humans being born with the ‘same’ brain, the mind IS independent of culture.

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We are all products of our own culture

You are a product of your own culture, meaning the culture you are born and raised in shapes you into the individual you are today. Being part of a culture signifies specific characteristics, knowledge, and experiences consisting of language, religion, customs, cuisine, beliefs, child-rearing practices, social habits, arts, music and much more. These factors make up cultural group identities, some being more specific to certain cultures in comparison to different cultures. As individuals of society, we are exposed to these characteristics at different levels throughout our lifetime. For example, if you come from a very religious family, you may practice prayer and attend church regularly - you are taught by your family at a young age this ‘norm’ and are exposed to these beliefs and values to some extent. When you are grown, you may practice these same traditions with your own family, and so forth. Because people in different cultures have different experiences, these experiences help shape our psychological processes (but not necessarily determine them). The way we learn and attent to cultural norms, our perceptions on certain values can be shaped by the cultures we live in. Due to the familiarity of our own culture, we view other cultures as “foreign” or “exotic” because it differentiates from what we are used to. For example, we view North American culture as “normal”, however, to other countries our considerations of “normal” are, in fact, quite different from each other.

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Hookup Culture - millennials perception of 'love'

Prior to reading associated articles and class material, I haven’t thought of hookup culture in such depth. Despite its significance and relavancy (especially within university settings), hookup culture is a topic that is often ignored and not discussed as much as it should, especially in modern times. We define ‘hooking up’ as sexual behaviors between partners with no desired plan for future plans of a romantic relationship. Hookup culture has taking over millennials perception of ‘love’, whereas traditional, old-school dating is rarely practiced anymore and is often considered to be absurd to millennials. In my opinion, this sort of behavior is impractical and it is difficult to wrap my head around to logic of preferring to get naked with someone you barely even know rather than getting to know somebody personally and going out for dinner with them...or even just a cup of coffee. ‘Hooking up’ is reportedly often associated with alcohol consumption which can obviously lead to nonconsensual sex, unplanned pregnancies and sexually transmitted diseases. In extreme cases, hooking up may also cause several psychological issues and trauma associated with undesired sexual experiences. Clearly, there are several negative outcomes associated with hookup culture, however, it is rarely addressed and will continue to be an issue for generations to come if we do not do anything about it. Hookup culture is also often associated with pluralistic ignorance, referring to how the majority of a group (in this example, university students) may internally reject a norm, but alternatively go along with it anyway because they believe that other people will accept it. It was interesting reading Reiber and Garcia’s (2010) article where they demonstrated behavioral-evolutionary theory - both sexes overestimated the other sex in terms of sexual behaviors and comfort levels.

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COVID-19 impact on different cultures

Consider contemporary news events that call for a consideration of how culture plays a role in the event, reflect on these events using your knowledge of culture and human psychology

While reflecting on this question, the most current and obvious example that came to mind referring to contemporary news is COVID-19 and it’s significant impact on different cultures around the world. As COVID-19 began its spread across the world, it was very interesting to me to view how different cultures reacted to this major emergency and the way several countries worked together by implementing new strategies to fight the virus. These cross-cultural comparisons opened my eyes and truly made me feel fortunate to be living in Canada in a time ofa global crisis. By following the daily news, we all became fairly aware of the health risks associated with COVID-19 (i.e. precautions, symptoms, etc), as well as the most vulnerable populations - however, the news does not portray other cultural factors associated with vulnerability and COVID-19. Cultural factors such as social class, race, gender, and religion are often overlooked in the media and we are not as familiar with how these factors are associated with COVID-19 vulnerability. A particularly relevant example reflecting these factors is COVID-19’s impact within Indigenous communities. Colonialism has previously shaped how Indigenous communities live in our society today and several inequalities and health disparities are certainly amplified during the ongoing pandemic. Comorbidities (i.e. diabetes, heart disease, depression, etc.) make up a large portion of the Indigenous population who are, therefore, more vulnerable to COVID-19. Poor living conditions amongst several reserves such as poor housing (i.e. overcrowding) and plumbing that can lead to substandard sanitation and a higher susceptibility to COVID-19.

Not only is global health (i..e prevention, treatment, and care) being challenged during this difficult time but also the government’s role in handling this new situation. A very clear example is within the United States as they have the highest rates of both cases and mortalities associated with COVID-19 - cultural factors such as dietary patterns (and obesity rates), living conditions, health care systems are also potentially associated with these outcomes. This demonstrates how living conditions, health infrastructures and resource access can dictate positive or negative outcomes. Having the appropriate resources can manage the number of cases and mortalities amongst the population which is why many cultures are lacking since they have insufficient access these resources - resulting in different outcomes worldwide.