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The 6-D Model of National Culture as a Tool to Examine Cultural Interpretation of Migration Trauma-Related Dissociative Disorder: A Case Series

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Abstract

Dissociative experiences are common in traumatized individuals who can use dissociation as a psychological escape from emotional and physical distress associated with overwhelming traumatic events. Traumatic experiences and the cultural interpretation of trauma-related symptoms often serve to explain the wide range of dissociative phenomenology; in fact, dissociation is a complex and ubiquitous construct present in a variety of mental disorders. The Six-Dimensions Model of National Culture has been used as a tool to compare patients’ different cultural background that could have accounted for the different clinical manifestations. This paper reports three clinical cases in which the focus of interest is represented by the dissociative alterations of consciousness, as a response to trauma, specifically related to migration, and their correlation with cultural environment. The study shows as Hofstede’s model has been used for the first time as a tool to explain how different cultural background could shape clinical manifestations.

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References

  1. American Psychiatric Association. Diagnostic and statistical manual of mental disorders (DSM-5®). Washington: American Psychiatric Publishing; 2013.

    Book  Google Scholar 

  2. Lewis-Fernandez R. A cultural critique of the DSM-IV dissociative disorders section. Transcult Psychiatry. 1998;35(3):387–400.

    Article  Google Scholar 

  3. Kirmayer LJ, Santhanam R. The Anthropology of Hysteria. In: Halligan P, Bass C, Marshall J, editors. Contemporary approaches to the study of hysteria: clinical and theoretical perspectives. Oxford: Oxford University Press; 2001. p. 251–70.

    Google Scholar 

  4. Seligman R, Kirmayer JL. Dissociative experience and cultural neuroscience: narrative, metaphor and mechanism. Cult Med Psychiatry. 2008;32(1):31–64.

    Article  PubMed  PubMed Central  Google Scholar 

  5. Baita S. Coping with childhood trauma and dissociation in Argentina. J Trauma Pract. 2006;4(1–2):35–53.

    Article  Google Scholar 

  6. Gingrich HJD. An examination of dissociative symptoms as they relate to indigenous Filipino concepts. Soc Sci Diliman. 2006;3(1–2):1–48.

    Google Scholar 

  7. Sar V, Alioglu F, Akyüz G. Experiences of possession and paranormal phenomena among women in the general population: are they related to traumatic stress and dissociation? J Trauma Dissociation. 2014;15(3):303–18.

    Article  PubMed  Google Scholar 

  8. Carrer S, Meuti V, Catino E, Pucci D, Lafuente M, Colosimo F, Aragona M, Mazzetti M, Maisano B, Geraci S. Immigrazione, traumi, diffcoltà vitali e psicopatologia: uno studio preliminare in un setting di medicina generale. Riv Psichiatr. 2011;46:129–39.

    PubMed  Google Scholar 

  9. Poloni N, Diurni M, Buzzi A, Cazzamalli S, Aletti F, Baranzini F, Vender S. Recovery style, symtoms and psychological functioning in psychotic patients: a preliminary study. Riv Psichiatr. 2013;48(5):386–92.

    PubMed  Google Scholar 

  10. Fortuna LR, Porche MV, Alegria M. Political violence, psychosocial trauma, and the context of mental health services use among immigrant Latinos in the United States. Ethn Health. 2008;13:435–63.

    Article  PubMed  PubMed Central  Google Scholar 

  11. Kaltman S, Green BL, Mete M, Shara N, Miranda J. Trauma, depression, and comorbid PTSD/depression in a community sample of Latina immigrants. Psychol Trauma. 2010;2:31–9.

    Article  PubMed  PubMed Central  Google Scholar 

  12. Aragona M, Pucci D, Mazzetti M, Maisano B, Geraci S. Traumatic events, post-migration living difficulties and post-traumatic symptoms in first generation immigrants: a primary care study. Ann Ist Super Sanità. 2013;49(2):169–75.

    PubMed  Google Scholar 

  13. Lavik NJ, Hauff E, Skrondal A, Solberg O. Mental disorder among refugees and the impact of persecution and exile: some findings from an outpatient population. Br J Psychiatry. 1996;169:726–32.

    Article  CAS  PubMed  Google Scholar 

  14. Burnett A, Peel M. Asylum seekers and refugees in Britain. The health of survivors of torture and organised violence. BMJ. 2001;322:606–9.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  15. Health of Londoners Project. Refugee health in London: key issues in public health. London: East London & City Health Authority; 1999.

    Google Scholar 

  16. Bhui K, Abdi A, Abdi M, Pereira S, Dualeh M, Robertson D, Sathyamoorthy G, Ismail H. Traumatic events, migration characteristics and psychiatric symptoms among Somali refugees. Soc Psychiatry Psychiatr Epidemiol. 2003;38:35–43.

    Article  PubMed  Google Scholar 

  17. Kirmayer LJ. Beyond the “new cross-cultural psychiatry”: cultural biology, discursive psychology and the ironies of globalization. Transcult Psychiatry. 2006;43:126–44.

    Article  PubMed  Google Scholar 

  18. Kleinman A. Depression, somatization and the “new cross-cultural psychiatry”. Soc Sci Med. 1977;11:3–10.

    Article  CAS  PubMed  Google Scholar 

  19. Callegari C, Diurni M, Bianchi L, Aletti F, Vender S. L’Entreveu puor la vue d’ensamble culturelle (DSM-5) et Cultural Formulation de deux cas cliniques: interférence de la spiritualité et de la religion au début du processus psychopathologique. Evol Psychiatr. 2016;81(1):191–201.

    Article  Google Scholar 

  20. Arasaratnam LA. Perception and communication in intercultural spaces. Lanham: University Press of America; 2011.

    Google Scholar 

  21. Hofstede G. Culture’s consequences: international differences in work-related values. Beverly Hills: Sage; 1980.

    Google Scholar 

  22. Hofstede G, Hofstede GJ, Minkov M. Cultures and organizations: software of the mind. 3rd ed. New York: McGraw-Hill; 2010.

    Google Scholar 

  23. Hofstede G. Dimensionalizing cultures: the Hofstede model in context. Online Read Psychol Cult. 2011;2(1):1–25.

    Google Scholar 

  24. Caplan S, Buyske S. Depression, help-seeking and self-recognition of depression among dominican, ecuadorian and colombian immigrant primary care patients in the Northeastern United States. Int J Environ Res Public Health. 2015;12:10450–74.

    Article  PubMed  PubMed Central  Google Scholar 

  25. Kramer EJ, Guarnaccia P, Resendez C, Lu FG: No Estoy Loco/I’m Not Crazy: understanding the stigma of mental illness in latios—a guide, 2009. https://ethnomed.org/clinical/mental-health/Facilitators%20Guide%20123108%20final%20_2_.pdf/view.

  26. Caselli I, Poloni N, Ielmini M, Diurni M, Callegari C. Epidemiology and evolution of the diagnostic classification of factitious disorders in DSM-5. Psychol Res Behav Manag. 2017;10:387–94.

    Article  PubMed  PubMed Central  Google Scholar 

  27. Callegari C, Bortolaso P, Vender S. A single case report of recurrent surgery for chronic back pain and its implications concerning a diagnosis of Münchausen syndrome. Funct Neurol. 2006;21(2):103–8.

    CAS  PubMed  Google Scholar 

  28. Kinzie JD. Overview of clinical issues in the treatment of Southeast Asian refugees. In: Owan TC, editor. Southeast Asian mental health: Treatment, prevention, services, training, and research. Washington: US Government Printing Office; 1985. p. 113–36.

    Google Scholar 

  29. Albert U, Carmassi C, Cosci F, De Cori D, Di Nicola M, Ferrari S, Poloni N, Tarricone I, Fiorillo A. Role and clinical implications of atypical antipsychotic in anxiety disorders, obsessive-compulsive disorder, trauma-related, and somatic symptoms disorders: a systematized review. Int Clin Psychopharmacol. 2016;31(5):249–58.

    Article  PubMed  Google Scholar 

  30. Diurni M, Baranzini F, Costantini C, Poloni N, Vender S, Callegari C. Metabolic side effects of second generation antipsychotic in drug-naïve patients: a preliminary study. Riv Psichiatr. 2009;44(3):176–8.

    PubMed  Google Scholar 

  31. Gold SN. Fight club; a depiction of contemporary society as dissociogenic. J Trauma Dissociation. 2004;5(2):13–34.

    Article  Google Scholar 

  32. Schetky DH. A review of the literature on the long-term effects of childhood sexual abuse. In: Kluft RP, editor. Incest-related syndromes of adult psychopathology. Washington: American Psychiatric Press; 1990.

    Google Scholar 

  33. Davies JM, Frawley MG. Treating the adult survivor of childhood sexual abuse. New York: Basic Books; 1994.

    Google Scholar 

  34. Howell EF. “Good girls”, sexy “bad girls”, and warriors: the role of trauma and dissociation in the creation and reproduction of gender. J Trauma Dissociation. 2002;3(4):5–32.

    Article  Google Scholar 

  35. Pfeifer S. Belifies in demons and exorcism in psychiatric patients in Switerland. Br J Med Psychol. 1994;67:247–58.

    Article  PubMed  Google Scholar 

  36. Dow HD, Woolley SR. Mental health perceptions and coping strategies of Albanian Immigrants and their families. J Martial Fam Ther. 2011;32(1):95–108.

    Article  Google Scholar 

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Callegari, C., Ielmini, M., Caselli, I. et al. The 6-D Model of National Culture as a Tool to Examine Cultural Interpretation of Migration Trauma-Related Dissociative Disorder: A Case Series. J Immigrant Minority Health 22, 588–596 (2020). https://doi.org/10.1007/s10903-019-00904-7

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