Chapter 11

Cultural Factors of Psychological

Disorders
PSY 2023 CROSS-CULTURAL PSYCHOLOGY
Learning Objective
At the end of this chapter, students are able to:

1. Define abnormality across culture

2. Describe the cultural variations of psychological disorders

PSY 2023 CROSS-CULTURAL PSYCHOLOGY 2

1.1 Abnormality across culture
 Psychological disorder
 Any pattern of behaviour or thinking that causes people significant distress, causes them
to harm others, or harms their ability to function in daily life.
 Abnormality can be defined as a deviation from social norms 
 This means that we label people as abnormal if their behaviour is different from what we
accept as the norms of society.
 Some psychologist use statistics to define normality more objectively
 Statistical abnormality
 abnormality defined on the basis of an extreme score on some dimension such as IQ or
anxiety.
 Refers to scoring very high or low on some dimension such as intelligence, anxiety or
depression
 Example : Anxiety
 create a test to learn how many people show low, medium or high levels of anxiety

PSY 2023 CROSS-CULTURAL PSYCHOLOGY 3

1.2 Assessing abnormality/mental disorder
 Mental Disorder
 is defined as clinically significant disturbance in an
individual’s cognitive, emotion regulation, or
behavior that reflects a dysfunction in the
psychological, biological or developmental processes
underlying mental functioning (APA, 2013).
 How psychological disorders are diagnosed and
classified
 Diagnostic and Statistical Manual of Mental
Disorders (DMS)
 Have revised multiple times (latest: DMS-5)
 Describes and provides diagnostic criteria for
approximately 250 different psychological disorder

PSY 2023 CROSS-CULTURAL PSYCHOLOGY 4

2.1 Cultural variations of psychological disorders

Schizophrenia Depression

Cultural-
Somatisation bound
syndrome
PSY 2023 CROSS-CULTURAL PSYCHOLOGY 5
a) Schizophrenia
 SCHIZOPHRENIA = a group of psychotic disorders featured by:
 gross distortions of reality,
 withdrawal from social interaction, and
 disorganisation of thought, perception, and emotion
(Carlson , Butcher, & Coleman, 1988).

 The etiology (penyebab) of schizo is due to biological (excess of dopamine or

biochemical imbalances) and environmental factors (e.g. hostility in family).
 Diathesis-stress model  those who are biologically predisposed to schizo, and
living in hostile environment, have more chances to become one (schizoic).

PSY 2023 CROSS-CULTURAL PSYCHOLOGY 6

a) Schizophrenia
 The WHO research (1973, 1979, 1981) was conducted in comparing the
prevalence and course of schizophrenia in several continents.
 found that research assessment in diagnosing schizophrenia was reliable.
 also, similar (universal) symptoms found for schizophrenia, i.e. lack of insight,
auditory and verbal hallucinations, and ideas of reference ( that becoming the
centre of attention).

 HOWEVER……
 People of developing countries (i.e. Colombia, India and Nigeria) recovered at
faster rates than those of highly industrialised countries (e.g. USA, UK)
 These differences were attributed to cultural factors, such as the presence of kin
networks (a lot of relatives to turn to for support) and the tendency to hurry back
to work (no work, no money, no food on the table)
PSY 2023 CROSS-CULTURAL PSYCHOLOGY 7
a) Schizophrenia
 Research evidence:
 Murphy (1982) – Irish admitted for schizophrenia 4 times higher than the
English and Welsh

 Sue & Morishima (1982) – Schizoic Japanese were more withdrawn and
passive than their European counterparts  reflecting the Japanese culture.

 Expressed emotion as a mechanism in identifying relapse cases in

schizophrenia patients may raise a question as whether or not it is
appropriate to be used amongst cultures that do not encourage verbal
communication (Kleinman, 1988).

PSY 2023 CROSS-CULTURAL PSYCHOLOGY 8

b) Depression
 Depression = “intense sadness, feelings of futility and worthlessness, and
withdrawal from others” (Sue, Sue & Sue, 1990).
 Depression = characterised by physical changes, emotional and behavioral
changes.
 Some cultures (e.g. Nigerians) are less likely to report extreme feelings of
worthlessness.
 Others (e.g. Chinese) are more likely to report somatic complaints.
 Rates of depression also vary from culture to culture.

PSY 2023 CROSS-CULTURAL PSYCHOLOGY 9

c) Somatization
 Somatization
 the manifestation of psychological
distress by the presentation of
physical symptoms.
 People with somatization disorder do
not face their illnesses. They honestly
feel pain or believe they cannot move
their limbs.
 Japanese, and Chinese > somaticize
more than Europeans/ Americans

PSY 2023 CROSS-CULTURAL PSYCHOLOGY 10

 d) Culture-bound syndrome
 Culture-bound syndrome – forms of abnormal behaviour observed only in
certain sociocultural milieus.

 Types of culture-bound syndrome

 Amok  Others:
 sudden rage and homicidal aggression; probably due to stress, less  whakama (in New Zealand)
sleep, & alcohol consumption.
 Avanga – In Tonga
 Witiko – (windigo)
 amongst Alongquin Indians in Canada  Latah – amongst Malay
 man-eating monster suicide to avoid cannibalistic urges.
women in South EastAsia,
esp. in Malaysia.
 Zar
 an altered state of consciousness amongst Ethiopian immigrants to
 Koro – retracting of penis,
Israel. Believe to be possessed bu Zar spirit, expressed by in Southeast Asian man.
involuntary movement, mutism, and incomprehensible language.
 Sinking heart
 condition of distress in the Punjabi culture, affecting heart or chest;
probably due to excessive heat, exhaustion, worry, or social failure
PSY 2023 CROSS-CULTURAL PSYCHOLOGY 11
2.2 Culture, assessment and treatment of abnormal behaviour

 In assessing abnormal behaviour, psychologist seek to classify abnormal

behaviours into categories.
 There is limitation on DSM and ICD-10 (International Classification of Diseases
10th ed.) in assessing abnormal behaviour.
 Cultural sensitive therapist should be knowledgeable in diverse cultures and
lifestyles, skillful and comfortable in using innovative treatment method, and
experienced in working with culturally diversified clients.

PSY 2023 CROSS-CULTURAL PSYCHOLOGY 12

Thank you

PSY 2023 CROSS-CULTURAL PSYCHOLOGY 13