The Role of Culture in Treatment of MDD & Phobias (HL IB Psychology)
Revision Note
Collectivist Cultures & Cultural Relativism: an overview
Collectivist Cultures: an overview
The Sociocultural Approach (examined on Paper 1) has culture as one of its main areas of focus e.g. culture and its effect on individual behaviour
One of the key topics in the IB Psychology study of culture is cultural dimensions (which you can find, along with the other Sociocultural topics, on this site)
The most-studied cultural dimension is the Individualism/Collectivism dimension
The bulk of the theories and studies that you cover in IB Psychology (and this will apply if you go on to study Psychology at degree level) use research from Western cultures i.e. the USA, the UK, Western Europe, Australia which are all individualistic cultures
Collectivist cultures can be characterised in the following ways:
An emphasis on we/us rather than I/me
Priority is given to the group rather than to the individual
Cultural norms may centre around behaviours which benefit the family/community/society e.g. living with extended family; sharing earnings with the family or the community as a whole; older people being awarded due respect and status; rituals and ceremonies which celebrate long-established traditions
Collectivist cultures have been studied alongside individualistic cultures in cross-cultural research with an emphasis on comparison of both cultures on key variables e.g. conformity
Are you a ‘me’ or a ‘we’?
Why is Culture an Issue in the Treatment of Disorders?
Cultural Relativism
One of the problems with cross-cultural research is that it may result in universal, ethnocentric or etic conclusions being made i.e. the researcher(s) may (consciously or unconsciously) view their findings through the prism of their own cultural perspective
Cultural relativism (CR) is the idea that not all cultures are the same and there is no one ‘superior’ culture: diversity should be respected and accounted for in research
CR emphasises the idea that behaviour should be understood in the context of the culture itself rather than making judgements based purely on the behaviour in question
Using a CR approach to research involves a lack of judgement of cultures which are different from the cultural norms of whomever is conducting the research
CR means that a researcher should try to understand cultural practices from within that culture so that instead of making value-judgements about the culture, the researcher asks interested questions e.g. ‘Why is it that latah exists in Malaysia and Indonesia?’ (latah presents as hypersensitivity to sudden fright, often with echopraxia, echolalia, command obedience, and dissociative or trancelike behaviour)
A zar ritual, designed to cure the person who has been possessed by a spirit.
Culture & mental health
Culture & mental health
The topic of clinical biases in diagnosis (which you can find on this site) considers culture-bound-syndromes (CBS), concluding that Western individualistic clinicians who are not familiar with CBS may mis-diagnose mental disorders due to a lack of cultural knowledge
Different cultures have different values so trying to apply a universal model of treatment (specifically, the biomedical model with its emphasis on physiological etiology of disorders) across cultures does not account for CR
Some cultures are wary of disorders such as MDD so their criteria for treating depressive symptoms will be based on their own cultural understanding of the condition rather than on a course of antidepressants
In Ethiopia there is a CBS known as zar which a Western clinician may treat as MDD (as it involves weeping, apathy, withdrawal, loss of appetite), whilst ignoring the cultural context which is that symptoms are attributed to spirit possession with the possibility of the person developing a long-term relationship with the possessing spirit
In China there is a CBS known as shenkui which a Western clinician may treat as an anxiety disorder such as phobia (as it involves panic), whilst ignoring the cultural context which is that symptoms are attributed to excessive semen loss from frequent intercourse, masturbation, nocturnal emission i.e. excessive semen loss is feared because it thought to be life-threatening
Which studies investigate the role of culture in treatment of MDD & phobias?
Hodge & Nadir (2008) - A review of four therapeutic approaches to treatment of MDD and phobias
Hinton et al. (2005) - the efficacy of CBT for Cambodian refugees
Both Hodge & Nadir (2008) and Hinton et al. (2005) are available as Two Key Studies of the Role of Culture in Treatment of MDD & Phobias: just navigate the Treatment of Disorders section to find them
Exam Tip
It is important to acknowledge that CBS are part and parcel of the rich fabric of a culture and that globalisation may be eroding traditional beliefs and practices. Deeming one cultural practice ‘inferior’ (by possibly suggesting that CBS and their accompanying treatments are ‘unscientific’) is an example of imperialism and ethnocentrism which should be avoided where possible.
Worked Example
The question is ‘Contrast two approaches to treating disorders’ [22]
‘Contrast’ means that you should focus on the differences between two separate approaches, using relevant research with good use of examples and critical thinking. Here is an exemplar for guidance:
Research which is mindful and respectful of culture and its role both in diagnosis and treatment of disorders could be said to contrast starkly with the biological approach (using the biomedical model) to treating disorders. The biological approach leans heavily on drug therapy such as antidepressants which are based on theories such as the monoamine hypothesis (using biomedical model assumptions), placing the etiology of MDD on an imbalance of brain chemicals. Taking an approach which acknowledges the role of cultural relativism in treatments would likely ignore the use of drugs to treat culture bound syndromes and would instead use traditional treatments which align with their culture and make sense to the patient.
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