Abstract
The purpose of the present study was to compare the expression and frequency of somatic, affective and cognitive symptoms of distress across Turkish and U.S. university students. An open-ended free-list question was used to elicit distress responses from 827 Turkish and U.S. participants. The coding was done using classical content analysis. It was found that Turkish students reported equal amounts of affective, cognitive, behavioral, somatic, interpersonal and coping responses, whereas the U.S. students reported more affective and somatic symptoms than other response categories. U.S. students reported more affective and somatic symptoms than the Turkish students and the Turkish students listed more behavioral, interpersonal, and coping responses than the U.S. students. Turkish students’ tendency to report more behavioral, coping, and interpersonal responses is consistent with the collectivist nature of Turkish society. U.S. students’ tendency to report higher levels of somatic symptoms contradicts the findings from the WHO primary care study (Gureje et al. American Journal of Psychiatry 154:989–995, 1997). Limitations of the study and research and counseling implications of the findings are discussed.
Similar content being viewed by others
References
American Psychiatric Association. (1987). Diagnostic and statistical manual of mental health disorders (3rd ed., rev.). Washington: Author.
American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders (4th ed., rev.). Washington: Author.
Baarnhielm, S. (2003). Clinical encounters with different illness realities: Qualitative studies of illness meaning and restructuring of illness meaning among two cultural groups of female patients in a multicultural area of Stockholm. Division of Psychiatry, Karolinska Institutet. http://diss.kib.ki.se/2003/91-7349-641-3.
Bergin, A. E., & Garfield, S. L. (1994). Handbook of psychotherapy and behavior change (4th ed.). NY: Wiley.
Bernstein, D. M. (1997). Anxiety disorders. In W. Tseng & J. Streltzer (Eds.), Culture and psychopathology (pp. 46–66). New York: Brunner/Mazel.
Çarkoğlu, A., & Toprak, B. (2000). Turkiye’de din, toplum ve siyaset [Religion, society, and politics in Turkey]. Istanbul: TESEV Yayınları.
Chaplin, S. L. (1997). Somatization. In W. Tseng & J. Streltzer (Eds.), Culture and psychopathology (pp. 1–27). New York: Brunner/Mazel.
Cimilli, C. (1997). Depresyonla ilişkileri bağlamında Türkiye’nin sosyal ve kültürel özellikleri [Social and cultural characteristics of Turkey in the context of their relation to depression]. Türk Psikiyatri Dergisi, 8, 292–300.
Cohen, J. (1960). A coefficient of agreement for nominal scales. Educational and Psychological Measurement, 20, 37–46.
Escobar, J. I., Rubio-Stipec, M., Canino, G., & Karno, M. (1989). Somatic symptom index (SSI): a new abridged somatization construct. The Journal of Nervous and Mental Disease, 177, 140–146.
Fabrega, H. Jr. (1982). Culture and psychiatric illness: Biomedical and ethnomedical aspects. In A. J. Marsella & G. M. (Eds.), White, cultural conceptions of mental health and therapy (pp. 39–68). Holland: Reider.
Farooq, S., Gahir, M. S., Okyere, E., Sheikh, A. J., & Oyebode, F. (1995). Somatization: a transcultural study. Journal of Psychosomatic Research, 39, 883–888.
Fleisher, M. S., & Harrington, J. A. (1998). Freelisting: Management at a women’s federal prison camp. In V. C. de Munck & E. J. Sobo (Eds.), Using methods in the field (pp. 69–84). CA: Altamira.
Good, B. J., & Good, M. J. D. (1980). The meaning of symptoms: A cultural hermeneutic model for clinical practice. In L. Eisenberg & A. Kleinman (Eds.), The relevance of social sciences for medicine (pp. 165–196). Dordrecht: Reidel.
Gureje, O., Simon, G. E., Üstün, T. B., & Goldberg, D. P. (1997). Somatization in cross cultural perspective: a World Health Organization study in primary care. American Journal of Psychiatry, 154, 989–995.
Hofstede, G. (1991). Cultures and organizations: Software of the mind. London: McGraw-Hill.
Kaygısız, A., & Alkın, T. (1999a). Konversiyon bozukluğunda 1. ve 2. Eksen ruhsal bozukluk eştanıları [Comorbidity of Axis-I and Axis-II mental disorders in conversion disorder]. Türk Psikiyatri Dergisi, 10, 33–39.
Kaygısız, A., & Alkın, T. (1999b). Konversiyon bozukluğundaki ruhsal bozukluk eştanilarının sosyodemografik değişkenlerle ilişkisi [The relationship of comorbidity in conversion disorder to sociodemographic variables]. Türk Psikiyatri Dergisi, 10, 40–49.
Keyes, C. L. M., & Ryff, C. D. (2003). Somatization and mental health: a comparative study of the idiom of distress hypothesis. Social Science and Medicine, 57, 1833–1845.
Kirmayer, L. J. (1984). Culture, affect and somatization. Transcultural Psychiatric Research Review, 21, 159–262.
Kirmayer, L. J., & Taillefer, S. (1997). Somatoform disorders. In S. M. Turner & M. Hersen (Eds.), Adult psychopathology and diagnosis (3rd ed., pp. 333–383). New York: Wiley.
Kirmayer, L. J., Dao, T. H. T., & Smith, A. (1998). Somatization and psychologization: Understanding cultural idioms of distress. In S. O. Okpaku (Ed.), Clinical methods in transcultural psychiatry (pp. 233–265). Washington DC: American Psychiatric.
Kleinman, A. M. (1980). Depression, somatization and the “new cross-cultural psychiatry”. Social Science and Medicine, 11, 3–10.
Koptagel-İlal, G., Tuncer, C., & Özer, C. (1980). Effects of social environment on psychosomatic symptomatology in a transitional society. In G. Koptagel & O. Tuncer (Eds.), Proceedings of the 13th European Conference on Psychosomatic Research. Istanbul: Bozak Basımevi.
Krueger, R. F., Chentsova-Dutton, Y. E., Markon, K. E., Goldberg, D., & Ormel, J. (2003). A cross-cultural study of the structure of comorbidity among common psychopathological syndromes in the general health care setting. Journal of Abnormal Psychology, 112, 437–448.
Landis, J. R., & Koch, G. G. (1977). The measurement of observer agreement for categorical data. Biometrics, 35, 159–174.
Locke, D. C. (1998). Increasing multicultural understanding (2nd ed.). Newbury Park: Sage.
Marsella, A. J. (1980). Depressive experience and disorder across cultures. In H. C. Triandis & J. G. Draguns (Eds.), Handbook of cross-cultural psychology (Vol. 6, pp. 233–262). Boston: Allyn and Bacon.
Mirdal, G. M. (1985). The condition of “tightness”: the somatic complaints of Turkish migrant women. Acta Psychiatrica Scandinavica, 71, 287–296.
Mocan-Aydın, G. (2000). Western models of counseling and psychotherapy within Turkey: crossing cultural boundaries. The Counseling Psychologist, 28, 281–298.
Nakamura, K., Kitanishi, K., Miyake, Y., Hashimoto, K., & Kubota, M. (2002). The neurotic versus delusional subtype of taijin-kyofu-sho: their DSM diagnoses. Psychiatry and Clinical Neurosciences, 56, 595–101.
Oltjenbruns, K. A. (1998). Ethnicity and the grief response: Mexican American versus Anglo American college students. Death Studies, 22, 141–156.
Özkan, M., Sır, A., Özçetin, A., & Ataoğlu, A. (1998). Bedenselleştiren hastalarda yaygın bunaltı bozukluğu, depresyon, ve bunaltılı depresyon [Generalized anxiety disorder, depression and anxious depression in somatizing patients]. Türk Psikiyatri Dergisi, 9, 107–113.
Paykel, E. S. (1992). Handbook of affective disorders (2nd ed.). New York: Guilford.
Rouhparvar, A. (2000). Acculturation, gender, and age as related to somatization in Iranians. Unpublished Dissertation, California School of Professional Psychology, Los Angeles.
Ryan, G. W., & Bernard, H. R. (2000). Data management and analysis methods. In N. K. Denzin & Y. S. Lincoln (Eds.), Handbook of qualitative research (2nd ed., pp. 769–802). CA: Sage.
Tanaka-Matsumi, J., & Draguns, J. G. (1997). Culture and psychopathology. In J. Berry, M. H. Segall, & Ç. Kağıtçıbaşı (Eds.), Handbook of cross-cultural psychology. Vol. 3. Social behavior and applications (2nd ed., pp. 449–491). Boston: Allyn & Bacon.
Tseng, W. (1997). Overview: Culture and psychopathology. In W. Tseng & J. Streltzer (Eds.), Culture and psychopathology (pp. 1–27). New York: Brunner/Mazel.
Uluşahin, A., Başoğlu, M., & Paykel, E. S. (1994). A cross-cultural comparative study of depressive symptoms in British and Turkish clinical samples. Social Psychiatry and Psychiatric Epidemiology, 29, 31–39.
Watson, W. H., & McDaniel, S. H. (2000). Relational therapy in medical settings: working with somatizing patients and their families. In Session: Psychotherapy in Practice, 56, 1065–1082.
World Health Organization. (1973). Report of the international pilot study of schizophrenia. Geneva: WHO.
World Health Organization. (1979). Schizophrenia: An international follow-up study. Geneva: WHO.
World Health Organization. (1983). Depressive disorders in different cultures: Report of the WHO collaborative study of standardized assessment of depressive disorders. Geneva: WHO.
World Health Organization. (1992). International classification of diseases (10th rev.). Geneva: World Health Organization.
Xu, J. M. (1987). Some issues in the diagnosis of depression in China. Canadian Journal of Psychiatry, 32, 368–370.
Yap, P. M. (2000). Mental diseases peculiar to certain cultures: A survey of comparative psychiatry. In R. Littlewood & S. Dein (Eds.), Cultural psychiatry and medical anthropology: An introduction and reader (pp. 179–196). New Jersey: Athlone.
Young, D. M. (1997). Depression. In W. Tseng & J. Streltzer (Eds.), Culture and psychopathology (pp. 28–45). New York: Brunner/Mazel.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Canel-Çınarbaş, D., Ægisdóttir, S. Somatic, Affective and Behavioral Distress Reactions Across Cultures. Int J Adv Counselling 32, 129–143 (2010). https://doi.org/10.1007/s10447-010-9094-0
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10447-010-9094-0