Culture Specific Mental Disorders

Culture Specific Mental Disorders

"Apparently, mental illness is present in all societies. However, the frequencies of different types of mental illness vary as do the social connotations. What is defined as a mild form of mental illness in one culture may be defined as normal behavior in another. For instance, people in western societies who regularly carry on animated conversations with dead relatives or other supernatural beings are generally considered mentally ill. The same behavior is likely to be considered healthy and even enviable in a culture that has an indigenous world-view. Such a person would be thought fortunate for having direct communication with the supernatural world. Traditionally among many Native American societies, dreams and the visionary world were, in a sense, more real and certainly more important than the ordinary world of humans."

For the rest of this truly fascinating article go here.

http://anthro.palomar.edu/medical/med_4.htm

Psychiatric syndromes which are endemic to particular cultures:

* amok or mata elap: (Malaysia) a dissociative episode characterized by a period of brooding followed by an outburst of violent, aggressive, or homicidal behavior directed at people and objects. The episode tends to be precipitated by a perceived insult or slight and seems to be prevalent only among males. The episode is often accompanied by persecutory ideas, automatism, amnesia for the period of the episode, exhaustion, and a return to premorbid state following the episode. Some instances of amok may occur during a brief psychotic episode or constitute the onset or exacerbation of a chronic psychotic process.
Similar to cafard or cathard (Polynesia), mal de pelea (Puerto Rico), iich'aa (Navaho), and syndromes found in Laos, Papua New Guinea, and the Philippines. Similar also to the nascent American folk-category of going postal.

* anorexia mirabilis or holy anorexia: (medieval Europe): severe restriction of food intake, associated with experience of religious devotion. Often not considered pathological within the culture. The terms are used by historians, and are not emic.

* anorexia nervosa (North America, Western Europe): severe restriction of food intake, associated with morbid fear of obesity. Other methods may also be used to lose weight, including excessive exercise. May overlap with symptoms of bulimia nervosa.

* boufée deliriante: (West Africa and Haiti) sudden outburst of agitated and aggressive behavior, marked confusion, and psychomotor excitement. It may sometimes be accompanied by visual and auditory hallucinations or paranoid ideation.
Similar to DSM-IV brief psychotic disorder.

* brain #######1 or brain fog: (West Africa) a condition experience by primarily male high school or university students. Symptoms include difficulties in concentrating, remembering, and thinking. Students often state that their brains are "fatigued". Additional symptoms center around the head and neck and include pain, pressure, tightness, blurring of vision, heat, or burning. "Brain tiredness" or fatigue from "too much thinking" is an idiom of distress in many cultures.
May resemble anxiety, depressive, or somatoform disorders in DSM-IV.

* bulimia nervosa (North America, Western Europe): binge eating followed by purging through self-induced vomiting, laxatives, or diuretics; and morbid fear of obesity. May overlap with symptoms of anorexia nervosa.

* dhat: (India) semen-loss syndrome, characterized by severe anxiety and hypochondriacal concerns with the discharge of semen, whitish discoloration of the urine, and feelings of weakness and exhaustion.
Similar to jiryan (India), sukra prameha (Sri Lanka), and shenkui (China).

* falling out or blacking out: (Southern U.S. and Caribbean) episodes characterized by sudden collapse, either without warning or preceded by feelings of dizziness or "swimming" in the head. The individual's eyes are usually open, but the person claims inability to see. The person usually hears and understands what is occurring around him or her, but feels powerless to move.
May correspond to DSM-IV conversion disorder or dissociative disorder

* ghost sickness: (American Indian groups) preoccupation with death and the deceased, sometimes associated with witchcraft. Symptoms may include bad dreams, weakness, feelings of danger, loss of appetite, fainting, dizziness, fear, anxiety, hallucinations, loss of consciousness, confusion, feelings of futility, amd a sense of suffocation.

* grisi siknis: (Miskito Indians, Nicaragua) symptoms include headache, anxiety, anger, aimless running. Some similarities to pibloktoq.

* Hi-Wa itck: (Mohave American Indians) insomnia, depression, loss of appetite, and sometimes suicide associated with unwanted separation from a loved one.

* hsieh-ping: (Taiwan) a brief trance state during which one is possessed by an ancestral ghost, who often attempts to communicate to other family members. Symptoms include tremor, disorientation and delirium, and visual or auditory hallucinations.

* hwa-byung or wool-hwa-bung: (Korea) "anger syndrome". Symptoms are attributed to suppression of anger and include insomnia, fatigue, panic, fear of impending death, dysphoric affect, indigestion, anorexia, dyspnea, palpitations, generalized aches and pains, and a feeling of a mass in the epigastrium.
See also bilis and colera, below.

* involutional paraphrenia: (Spain, Germany) paranoid disorder occurring in midlife.

* koro: (Malaysia) an episode of sudden and intense anxiety that the penis (or in the rare female cases, the vulva and nipples) will recede into the body and possibly cause death. The syndrome occasionally occurs in local epidemics.
This syndrome occurs throughout south and east Asia under different names: suo yang (China); jinjinia bemar (Assam); and rok-joo (Thailand). It has been identified in isolated cases in the United States and Europe, as well as among diasporic ethnic Chinese or Southeast Asians.
Click here for a more extensive discussion of shuk yang and koro.

* latah: (Malaysia and Indonesia) hypersensitivity to sudden fright, often with echopraxia, echolalia, command obedience, and dissociative or trancelike behavior. The Malaysian syndrome is more frequent in middle-aged women.
Similar syndromes include: amurakh, irkunii, ikota, olan, myriachit, and menkeiti (Siberian groups); bah-tschi, bah-tsi, and baah-ji (Thailand); imu (Ainu & Sakhalin, Japan); and mali-mali and silok (Philippines).

* locura: (Latin America) a severe form of chronic psychosis, attributed to an inherited vulnerability, the effect of multiple life difficulties, or a combination of the two. Symptoms include incoherence, agitation, auditory and visual hallucinations, inability to follow rules of social interaction, unpredictability, and possible violence.

* pibloktoq or Arctic hysteria: (Greenland Eskimos) an abrupt dissociative episode accompanied by extreme excitement of up to 30 minutes' duration and frequently followed by convulsive seizures and coma lasting up to 12 hours. The individual may be withdrawn or mildly irritable for a period of hours or days before the attack and will typically report complete amnesia for the attack. During the attack, the individual may tear off his or her clothing, break furniture, shout obscenities, eat feces, flee from protective shelters, or perform other irrational or dangerous acts.
The syndrome is found throughout the arctic with local names.

* qi-gong psychotic reaction: (China) an acute, time-limited episode characterized by dissociative, paranoid, or other psychotic or nonpsychotic symptoms that occur after participating in the Chinese folk health-enhancing practice of qi-gong. Especially vulnerable are individuals who become overly involved in the practice.
Click here for a more extensive discussion of qi-gong and qi-gong psychotic reaction.

* sangue dormido: (Portuguese Cape Verdeans) Literally "sleeping blood". Symptoms include pain, numbness, tremor, paralysis, convulsions, stroke, blindness, heart attack, infection, and miscarriage.

* shenjian shuairuo: (Chinese) equivalent to now-defunct diagnosis of "neurasthenia". Symptoms include physical and mental fatigue, dizziness, headaches and other pains, difficulty concentrating, sleep disturbance, and memory loss. Other symptoms include gastrointestinal problems, sexual dysfunction, irritability, excitability, and various signs suggesting disturbances of the autonomic nervous system.
Many cases would be DSM-IV criteria for major depressive disorder or an anxiety disorder.
Click here for a more extensive discussion of shenjian shuairo and neurasthenia.

* Shenkui (Chinese): marked anxiety or panic symptoms with accompanying somatic complaints for which no physical cause can be demonstrated. Symptoms include dizziness, backache, fatiguability, general weakness, insomnia, frequent dreams, and complaints of sexual dysfunction (such as premature ejaculation and impotence). Symptoms are attributed to excessive semen loss from frequent intercourse, masturbation, nocturnal emission, or passing of "white turbid urine" believed to contain semen. Excessive semen loss is feared because it represents the loss of one's vital essence and can thereby be life threatening.
Similar to dhat and jiryan (India); and sukra prameha (Sri Lanka).
Click here for a more extensive discussion of shenkui.

* shin-byung: (Korea) syndrome characterized by anxiety and somatic complaints (general weakness, dizziness, fear, loss of appetite, insomnia, and gastrointestinal problems), followed by dissociation and possession by ancestral spirits.

* shinkeishitsu: (Japan) syndrome marked by obsessions, perfectionism, ambivalence, social withdrawal, neurasthenia, and hypochondriasis.

* spell: (southern U.S.) a trance state in which individuals "communicate" with deceased relatives or with spirits. At times this is associated with brief periods of personality change. Spells are not considered medical events in the folk tradition, but may be misconstrued as psychotic episodes in a clinical setting.

* tabanka: (Trinidad) depression associated with a high rate of suicide; seen in men abandoned by their wives.

* taijin kyofusho: (Japan) a syndrome of intense fear that one's body, body parts, or bodily functions are displeasing, embarrassing, or offensive to other people in appearance, odor, facial expressions, or movements.
Similar in some respects to DSM-IV social phobia, and included in the official Japanese classification of mental disorders.

* windigo or witiko: (Algonkian Indians, NE US and Eastern Canada) Not in DSM-IV. Famous syndrome of obsessive cannibalism, now somewhat discredited. Wendigo was supposedly brought about by consuming human flesh in famine situations. Afterwards, the cannibal was supposed to be haunted by cravings for human flesh and thoughts of killing and eating humans.
Excellent review of the windigo literature in Lou Marano. "Windigo psychosis: the anatomy of an emic-etic confusion." In The Culture-Bound Syndromes. Ronald Simons and Charles Hughes. (eds.) Boston, MA: D. Reidel Publishing Company. 1985.

* zar: (Ethiopia, Somalia, Egypt, Sudan, Iran, and elsewhere in North Africa and the Middle East) experience of spirit possession. Symptoms may include dissociative episodes with laughing, shouting, hitting the head against a wall, singing, or weeping. Individuals may show apathy and withdrawal, refusing to eat or carry out daily tasks, or may develop a long-term relationship with the possessing spirit. Such behavior is not necessarily considered pathological locally.
For an ethnographic description of similar possession, see Vincent Crapanzano, Tuhami: portrait of a Moroccan.

Just and add on article.

CULTURAL FACTORS IN PSYCHIATRIC DISORDERS

http://www.mentalhealth.com/mag1/wolfgang.html

Its nowhere as good as that first article Devil! Thanks for that one, wow.

Understanding Culture Bound Syndromes is not difficult. First you should separate them into three groups. Obvious neurological problems and brain diseases should not be included as CBS’s. Those will produce physical brain damage and can be detected by exam or MRI, Nodding Disease, Africa.

The second group to eliminate are those that are common diseases with local or ethnic descriptions. Fever and vomiting should be you clue that the suspected CBS is a local physical disease. A young child as a victim is also an eliminator in this second group.

The third group is the most interesting. They will be described as a sudden onset episode that contains psychotic or dissociative elements. Violence, anger, and aggression are often mentioned in their descriptions. Those effected may hear voices and have hallucinations, Ghost Sickness. As in Windigo Psychosis they may have sudden onset delusions with impossible explanations; communicating with spirits, ancestors, or alien abductors. The victim usually recovers with no treatment necessary. Going Postal, Amok, and Iich’aa are some of these syndromes. Anorexia and bulimia should be included in CBS listings but they do not demonstrate a sudden episode. They are described as disturbed behavior and they are outcomes of the same underlying exposure.

ICU Psychosis suggests that intense exposure, every fifteen minutes around the clock, can produce these episodes in as little as five days. Note that this is an eyes-open phenomenon and the patient must be awake and doing something similar to daydreaming to have exposure happen.

Because observations are colored by the observer’s cultural background there will be overlaps and missing symptoms. Those observers may miss the dissociative or psychotic features.

What investigators have been missing is that there is a conflict of physiology, which was discovered when it caused mental breaks for Knowledge workers using the first close-spaced office workstations. The Cubicle eventually became the standard solution to prevent these mental breaks in business offices. Cubicles are designed so that everything on either side of a concentrating worker is stationary. The corner position for computers uses the converging cubicle walls to block side or peripheral vision.

As a problem of physiology, not desks, chairs and filing cabinets, the phenomenon can be created even in primitive societies. All that is necessary is to engage an activity that requires concentration, mental investment, and that there be a source of repeating detectable movement in the subject’s peripheral vision.

When the expected mental break happens, subjects and observers understand the episode in terms of local belief. Brain #######1, Africa, is believed to be caused by too much thinking. But if students sit in standard classroom arrangements the too-close side-by-side seating is the same design problem that caused problems for office workers in the 1960’s. This argues that ADD and ADHD should be CBS’s. The growth spurt at puberty increases body size and increases the probability that movement will be detected in peripheral vision. Students, unlike Knowledge workers, do not maintain a state of concentration for long hours each day. Most student exposure is occasional, low level, and random.


This opens the possibility that an activity the victim had just before the episode would allow inclusion in the third grouping; Qi Gong Psychosis and Kundalini Psychotic Episodes are created when those exercises are performed in groups. Eyes-open meditation substitutes for the concentration of Knowledge workers. Other members of the exercise group performing katas and poses beside victims supply the detectable movement to create the special circumstances found in a business office.

When the exercise is performed too often in a compact time frame the expected episode is limited and the person will recover with no treatment. But if the exposure is persistent but low level for long periods, a fixed bizarre-belief altered mental state is created. Believing that you can or have levitated, walked through solid objects, or can dematerialize, or become invisible at will, is psychotic.

These beliefs would not be considered as unusual by the authors of the DSM because they are part of the cultural belief set and religious beliefs. Advanced Gurus are revered as enlightened even though they make these claims of superhuman or supernatural powers.

Anytime two or more people are confined in too-small over-wintering housing they will have many opportunities to create the special circumstances to cause exposure to Visual Subliminal Distraction.

When large numbers of people live in bunkhouses (Jumping Frenchmen of Maine disease) or longhouses in the South Pacific (Latah) they will also have many opportunities to be exposed. Cabin Fever, a violent berserk episode from the fur-trapping period of US history, is not usually listed as a CBS but it fits the description of Going Postal or Amok.

In the case of Jumping Frenchmen of Maine disease the subjects were all French Canadian lumberjacks. That phenomenon was eventually connected to operant conditioning but the investigators were unaware of the conflict of physiology. They couldn’t find the source of operant conditioning. JFM disappeared when lumberjacks were replaced by heavy logging equipment but Latah still exists. It too is disappearing as longhouses are replaced by modern living arrangements.

When you consider the phenomenon as a form of operant conditioning then Anorexia and Bulimia should be viewed as fixed altered mental states similar to those of Qi Gong and Kundalini Yoga.


The links and additional information is at VisionAndPsychosis.Net. The pages of interest are:


http://visionandpsychosis.net/Culture_B ... dromes.htm

http://visionandpsychosis.net/Psychotic ... _Cause.htm

http://visionandpsychosis.net/Schizophrenia_Cause.htm