Culturally Specific Syndromes

Culturally Specific Syndromes: A guide for formulation and diagnosis



The Importance for Understanding Culturally Specific Syndromes as a Clinician

Ethical guidelines for counselors and psychologists outline that in order to be competent in these fields in working with clients and patients, clinicians should have some skill in working with cultures and understanding of cultural competency. [1] It is also important to understand culture and what it means to a diagnostic formulation of an individual, especially how the syndrome or presents itself within the culture and how the individual views and interprets their symptoms. This is because one’s culture has an influence on their view of reality, durations, and course of the mental illness. Furthermore, having a baseline understanding of culturally specific syndromes can increase competency in providing support and treatment to relieve distress caused by the presenting symptoms.

The American Psychiatric Association (2000)[2] outlines in the text revision of the fourth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR) outlines the following narratives necessary for creating a cultural formulation of an individual:

Cultural Identity of the Individual

  • Their ethnic or cultural background
  • Degree of involvement between their culture and the host culture
  • Language spoken and preferred language

Cultural Explanations of the Individual’s Illness to Identify

  • The vernacular used by the individual and their culture in reference to the distress they are experiencing
  • Symptoms
  • Need for social support
  • Meaning and perceived severity on an individual level as well as how it compares with their cultural norms
  • Perceived causes or explanations
  • How professional care is perceived within their culture
  • Symptoms
  • Need for social support
  • Meaning and perceived severity on an individual level as well as how it compares with their cultural norms
  • Perceived causes or explanations
  • How professional care is perceived within their culture

Cultural Factors Related to Psychosocial Environment and Levels of Functioning

  • Relevant interpretation of social stress
  • Available social support
  • Level of functioning
  • Level of disability

Cultural Elements of the Relationship Between the Individual and the Clinician


Identify differences between individual and clinician that may pose a problem in treatment in regard to:

  • Communication
  • Understanding
  • Level of relationship and interaction appropriate
  • Determining whether behavior is normal or pathological

Overall cultural assessment for diagnosis and care

  • Discuss how the individuals culture influence diagnosis, treatment, and care.

[3]

In order to understand culturally bound syndromes, it is important to study the nuances of culture as well as how they are conceptualized in the host culture. The DSM-IV-TR outlines 25 of the most studied culturally bound syndromes, and this page will make an attempt to identify some of these syndromes, the cultures they can be found in, and how they present within western industrialized culture.

These 25 culturally bound syndromes are identified and discussed further by clicking the links below:

  • amok
  • ataque de nervios
  • bills and colera (munia)
  • boufѐe delirante
  • brain fag
  • dhat
  • falling out or blacking out
  • ghost sickness
  • hwa-byung (wool-hwa-byung)
  • koro
  • latah
  • locura
  • mal de ojo (evil eye)
  • nervios
  • pinloktoq
  • qi-gong psychotic reaction
  • rootwork
  • sangue dormido (sleeping blood)
  • shenjing shuairuo (neurasthenia)
  • Shen-k'uei (Taiwan) or Shenkui (China)
  • Shin-byung
  • spell
  • susto (fright, or soul loss)
  • taijin kyofusho
  • zar

Additional Culturally Bound Syndromes Not Identified in the DSM-IV-TR:

  • empacho
  • espanto
  • hechisamiento[4]


References

  1. White Kress, V. E., Eriksen, K. P., Rayle, A.D., and Ford, S. J. W. (2005). The DSM-IV-TR and culture: Consideration for counselors. Journal of counseling and development, 83(1) p. 97-104.
  2. American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders (4th ed., text revision). Washington, DC: Author.
  3. (American Psychiatric Association, 2000, p. 897-898)
  4. Velásquez, R. J., Arellano, L. M., Mcneil, B. W. (2004). The handbook of Chicana/o psychology and mental health. Mahwah, NJ: Lawrence Erlbaum Associates.