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Cultural variations in the response to psychiatric disorders and emotional distress

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  • Kirmayer, Laurence J.

Abstract

Culture influences the experience and expression of distress from its inception. While Western psychiatry has identified several universal patterns of distress, there are significant geographical variations in the prevalence, symptomatology, course and outcome of psychiatric illness. Indirect evidence suggests that cultural differences in the recognition, labelling and interpretation of deviant behaviour affect the outcome of major psychiatric disorders as well as milder forms of distress. Emotion theory and the cultural concept of the person provide links between social and cognitive processes that contribute to the natural history of emotional distress. However, many current studies of ethnopsychology confound psychology (mechanisms of behaviour) and meta-psychology (theories of the self). Further advances in understanding the impact of culture on distress depend on the development of psychological and social theory that is neither ethnocentric nor naive about the wellsprings of action. Three arenas for further study are identified: (1) the handling of the gap between experience and expression; (2) the labelling of deviant behaviour and distress as voluntary or accidental; and, (3) the interpretation of symptoms as symbols or as meaningless events. Attention to these themes can guide re-thinking the assumptions of Western psychological and social theory.

Suggested Citation

  • Kirmayer, Laurence J., 1989. "Cultural variations in the response to psychiatric disorders and emotional distress," Social Science & Medicine, Elsevier, vol. 29(3), pages 327-339, January.
    • Handle: RePEc:eee:socmed:v:29:y:1989:i:3:p:327-339
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    Cited by:

    1. Ruma Bose, 1997. "Psychiatry and the Popular Conception of Possession Among the Bangladeshis in London," International Journal of Social Psychiatry, , vol. 43(1), pages 1-15, March.
    2. Coker, Elizabeth M., 2005. "Selfhood and social distance: Toward a cultural understanding of psychiatric stigma in Egypt," Social Science & Medicine, Elsevier, vol. 61(5), pages 920-930, September.
    3. Hagaman, Ashley K. & Wagenaar, Bradley H. & McLean, Kristen E. & Kaiser, Bonnie N. & Winskell, Kate & Kohrt, Brandon A., 2013. "Suicide in rural Haiti: Clinical and community perceptions of prevalence, etiology, and prevention," Social Science & Medicine, Elsevier, vol. 83(C), pages 61-69.
    4. Ferrazzi, Priscilla & Krupa, Terry, 2016. "“Symptoms of something all around us”: Mental health, Inuit culture, and criminal justice in Arctic communities in Nunavut, Canada," Social Science & Medicine, Elsevier, vol. 165(C), pages 159-167.
    5. Bridget Dolan & Kevin Polley & Ruth Allen & Kingsley Norton, 1991. "Addressing Racism in Psychiatry: Is the Therapeutic Community Model Applicable?," International Journal of Social Psychiatry, , vol. 37(2), pages 71-79, June.
    6. Keys, Hunter M. & Kaiser, Bonnie N. & Kohrt, Brandon A. & Khoury, Nayla M. & Brewster, Aimée-Rika T., 2012. "Idioms of distress, ethnopsychology, and the clinical encounter in Haiti's Central Plateau," Social Science & Medicine, Elsevier, vol. 75(3), pages 555-564.
    7. Main Huong Nguyen & Eric Hahn & Katja Wingenfeld & Iris T Graef-Calliess & Anita von Poser & Malte Stopsack & Hannah Burian & Annegret Dreher & Simon Wolf & Michael Dettling & Ronald Burian & Albert D, 2017. "Acculturation and severity of depression among first-generation Vietnamese outpatients in Germany," International Journal of Social Psychiatry, , vol. 63(8), pages 708-716, December.
    8. A. Furnham & R. Malik, 1994. "Cross-Cultural Beliefs About "Depression"," International Journal of Social Psychiatry, , vol. 40(2), pages 106-123, June.
    9. L. Stone & W.M.L. Finlay, 2008. "A Comparison of African-Caribbean and White European Young Adults' Conceptions of Schizophrenia Symptoms and the Diagnostic Label," International Journal of Social Psychiatry, , vol. 54(3), pages 242-261, May.
    10. Sylvia F. Kaaya & Bandy Lee & Jessie K. Mbwambo & Mary C. Smith-Fawzi & Melkizedek T. Leshabari, 2008. "Detecting Depressive Disorder With a 19-Item Local Instrument in Tanzania," International Journal of Social Psychiatry, , vol. 54(1), pages 21-33, January.
    11. Hanlon, Charlotte & Whitley, Rob & Wondimagegn, Dawit & Alem, Atalay & Prince, Martin, 2009. "Postnatal mental distress in relation to the sociocultural practices of childbirth: An exploratory qualitative study from Ethiopia," Social Science & Medicine, Elsevier, vol. 69(8), pages 1211-1219, October.
    12. Snell-Rood, Claire & Carpenter-Song, Elizabeth, 2018. "Depression in a depressed area: Deservingness, mental illness, and treatment in the contemporary rural U.S," Social Science & Medicine, Elsevier, vol. 219(C), pages 78-86.
    13. Chrysi K Kaparounaki & Chrysoula A Koraka & Eleni S Kotsi & Anna-Maria P Ntziovara & Gerasimos C Kyriakidis & Konstantinos N Fountoulakis, 2019. "Greek university student’s attitudes and beliefs concerning mental illness and its treatment," International Journal of Social Psychiatry, , vol. 65(6), pages 515-526, September.
    14. Antonello Barbati & Alessandro Geraci & Fabiana Niro & Letizia Pezzi & Marco Sarchiapone, 2022. "Do Migration and Acculturation Impact Somatization? A Scoping Review," IJERPH, MDPI, vol. 19(23), pages 1-11, November.
    15. Kienzler, Hanna, 2008. "Debating war-trauma and post-traumatic stress disorder (PTSD) in an interdisciplinary arena," Social Science & Medicine, Elsevier, vol. 67(2), pages 218-227, July.

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