Culture-bound syndromes, idioms of distress, and cultural concepts of distress: New directions for an old concept in psychological anthropology

Culture‑bound syndromes (CBS) and cultural concepts of distress include syndromes or disease manifestations whose occurrence is related to particular cultural contexts. The term CBS is controversial, because ultimately all psychiatric and medical conditions are associated with culture. They constitute different points of view on mental health based on alternative explanatory models of mental distress. These idioms of distress have experienced a growing interest in Western countries either by an increase in the number of cases or the influence that transcultural psychiatry has come to conquer. This review describes clinical, epidemiological and contextual characteristics of most commonly reported CBS and briefly discusses the relationship between culture and psychiatric disorders. Modern societies are increasingly multi‑ethnic and multicultural and thus, discussion of these concepts remains relevant, aiming to integrate CBS in current classification systems or establishing criteria that best define them as legitimate nosological entities.

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Wayne Ha, MA: Lesson plan for the DSM and cultural concepts of distress

PsycEXTRA Dataset ◽

10.1037/e504452020-001 ◽

2020 ◽

Author(s):

Wayne Ha

Keyword(s):

Lesson Plan ◽

Cultural Concepts ◽

Cultural Concepts Of Distress

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Ataques de Nervios

Unusual and Rare Psychological Disorders ◽

10.1093/med:psych/9780190245863.003.0017 ◽

2016 ◽

pp. 242-262 ◽

Cited By ~ 1

Author(s):

Roberto Lewis-Fernández ◽

Irene López

Keyword(s):

Puerto Rican ◽

Suicide Attempts ◽

Physical Symptoms ◽

Ataque De Nervios ◽

Cultural Concepts ◽

Response To Stress ◽

Cultural Concepts Of Distress ◽

Normative Response ◽

Severe Psychopathology ◽

Cultural Concept

Ataque de nervios has been studied for half a century, and is one of the best assessed cultural concepts of distress. Ataques were initially studied in Puerto Rican, Dominican, and Cuban samples by Latino researchers and anthropologists. Research indicates that ataques typically occur immediately after, or within a day of, a significant stressor. The characteristic symptoms of an ataque can be quite dramatic, and include emotional and physical symptoms along with displays of aggression and alterations in consciousness. In addition, 7%–14% of ataques result in suicide attempts. The chapter discusses this cultural concept of distress common among Latinos and shows how its relationship with psychopathology can vary depending upon the context, and can range from a normative response to stress to a marker of severe psychopathology.

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New Directions in Psychological Anthropology.

Man ◽

10.2307/2803582 ◽

1994 ◽

Vol 29 (1) ◽

pp. 248

Author(s):

Sam Migliore ◽

Teodore Schwartz ◽

Roy D' Andrade ◽

Claudia Strauss

Keyword(s):

Psychological Anthropology ◽

New Directions

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The integration of idioms of distress into mental health assessments and interventions: a systematic review

Global Mental Health ◽

10.1017/gmh.2019.5 ◽

2019 ◽

Vol 6 ◽

Cited By ~ 4

Author(s):

C. Cork ◽

B. N. Kaiser ◽

R. G. White

Keyword(s):

Mental Health ◽

Systematic Review ◽

Idioms Of Distress ◽

Research Attention ◽

Cultural Concepts ◽

Cosmin Checklist ◽

Health Related Research ◽

Health Related ◽

Global North ◽

Assessment Measures

Background.Psychiatric diagnostic manuals recognise the importance of local expressions of distress in culturally diverse settings [i.e. idioms/cultural concepts of distress (CCDs)], yet there is a lack of consensus on how these should be incorporated into mental health related research.Aims.To perform a narrative synthesis and critical review of research exploring how idioms/CCDs have been integrated into assessment measures and interventions.Method.A systematic review was conducted in accordance with PRISMA guidelines. An adapted version of the COSMIN checklist was used to assess the quality of the linguistic translation of the idioms/CCDs.Results.Twenty-nine papers were included in the final review. Primary qualitative research was the most common method of gathering information about idioms/CCDs. The majority of studies described integrating idioms/CCDs into assessment measures as opposed to interventions. Some studies used information relating to idioms/CCDs to develop novel assessment measures, while others adapted pre-existing assessment measures. The measures generated moderate to high levels of validity. Information relating to the linguistic translation conducted in the completion of the studies tended to be inadequately reported.Conclusions.Integrating information about idioms/CCDs into assessment measures can enhance the validity of these assessments. Allocating greater research attention to idioms/CCDs can also promote more equitable exchanges of knowledge about mental health and wellbeing between the Global North and the Global South.

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Understanding the cultural concept of “highly sensitive person” among bipolar patients

European Psychiatry ◽

10.1016/j.eurpsy.2017.01.668 ◽

2017 ◽

Vol 41 (S1) ◽

pp. S514-S514

Author(s):

M. Ioannou ◽

M. Dellepiane ◽

S. Olsson ◽

S. Steingrimsson

Keyword(s):

Bipolar Disorder ◽

Cognitive Processing ◽

Emotional Reactivity ◽

Case Series ◽

Cultural Concepts ◽

Highly Sensitive ◽

Cultural Concepts Of Distress ◽

Bipolar Patients ◽

Cultural Concept ◽

Sensitive Person

IntroductionThe concept of “highly sensitive person” is a cultural concept, which has become popular in western societies including Sweden. A highly sensitive person (HSP) is usually described as having hypersensitivity to external stimuli, different cognitive processing and high emotional reactivity. Although the concept lacks diagnostic validity, psychiatric patients may refer to this concept.AimsTo examine the feasibility of the Cultural Formulation Interview (CFI) and the clinical relevance of cultural concepts of distress among patients with bipolar disorder that report being a HSP.MethodsA case series of three patients with a diagnosis of bipolar disorder that report HSP. The CFI was conducted with all patients and the applicability of the DSM-5 cultural concepts of distress tested.ResultsIn all three cases, the CFI facilitated the clinical consultation as reported from the patients and in one of the cases also increased the treatment engagement. The HSP-concept could be conceptualized as a cultural syndrome, idiom of distress and as an explanatory model.ConclusionThe CFI and the cultural concepts of distress proved to be useful for understanding the concept of HSP as also they increased the cultural validity of the diagnostic interview. The three cases illustrate the challenges when encountering patients with other cultural references than clinicians. This highlights the necessity to integrate anthropological thinking in our current diagnostic work in order to reduce the “category fallacy” and promote a more person-centered approach in psychiatry.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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