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Cultural Considerations 

·       An individual’s behaviour is governed to an extent by the culture they are brought up in.

·       There are likely to be different perceptions of behaviour in different cultures, different cultural norms-stigmatizatization

·       A  tendency to favor one’s own cultural view of the world(cultral bias in diagnosis)

·       Studies on psychological disorders originated from the west, hence the tendency that the diagnosis system favor the western culture.

·       Cultrue bound syndromes ( specific to cuture)

 

Case Study: Depression in China 

 

 

 

Parker et al .

 

Aim: To investigate depression in China

 

Procedure: 

  • 50 Malaysian participants of Chinese heritage and 50 Australian participants of Caucasian, Western heritage

  • All participants were outpatients who had been diagnosed with Major Depressive Disorder 

  •  The questionnaire was based on two sets of symptoms: 1, a set of mood and cognitive items common in Western diagnostic tools for depression, 2  a set of somatic symptoms commonly observed by Singaporean psychiatrists (All questionnaires were translated 

  • Participants were asked to  judge the extent to which they had experienced each of the 39 symptoms in the last week

 

Result:

  • 60% of the Chinese participants identified physical symptoms.

  • the Chinese participants were significantly less likely to identify cognitive or emotional symptoms as part of their problem. 

  • They were less likely to rate feeling helpless and hopeless, a depressed mood, having poor concentration, or having thoughts of death than the Australian participants.

 

Strength: 

  • Culturally specific ( translations) 

  • Applicable: Can be used in diagnosis and understanding depression in China 

 

Limitation:

  • Self-reported data : may be biased, may have social desirability

  • Lack internal validity 

 

 

Implication about culture: China is a collectivistic country that stresses the need off a society as a whole. Individuals are not applauded for individuality and are encouraged to instead they are told to conceal their feelings for the good of the society as a whole. Therefore depression in China has been underdiagnosed and  seen has a physical symptom instead of one that deals with both emotional and physical aspects. In China Depression has been underdiagnosed and mostly ccontrinbuted to has  Neurasthenia. Zhang et al. (1998): a survey in China 16 out of 19233 were diagnosed with depression. 

 

 

 

Neurasthenia

( zhang et al )

  • This is a diagnosis no longer in the DSM but are used wildly in China

  • “Known to be weakening of the nerves

  • characterized by bodily symptoms- feeling of fatigue

  • related with the concept of vital energy – which is used in Chinese traditional medicine to diagnose Schwartz1- has many overlaps with depression

  • ( Tseng and Hsu 1970) –Chinese tend to concern a lot about body and will manifest neurasthenic symptom: sleep problems, concentration difficulty into depression and ignore the emotional part

 

 

 

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