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Understanding Genital-Shrinking Epidemics in West Africa: Koro, Juju, or Mass Psychogenic Illness?

Abstract

A small-scale epidemic of genital shrinking occurred in six West African nations between January 1997 and October 2003. This article presents a summary and analysis of 56 media reports of these cases. A clinical formulation of these cases considers a variety of explanations from theory and research in social and cultural psychology, psychopathology, and anthropology. Of particular interest is a comparison of genital-shrinking distress in West African settings with koro, a culture-bound syndrome involving fears of genital retraction that is prominent in Southeast Asian settings. The paper concludes with a brief discussion of the role of culture in both the experience of genital-shrinking distress and conceptions of psychopathology.

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References

  1. Abah, P. 2000 Organ Snatch At Oshodi. Electronic document, http://www.allAfrica.com/stories/printable/200010240314.html, accessed November 28, 2001.

  2. Ablekpe, B., and J.M. Opoku 1997 11 before Tribunal for False Alarm. Daily Graphic, January 21: 10.

  3. Adams, G. 2000 The Collective Construction of Enemyship in Ghana and the USA: Implications for the Study of Psychology and Culture. Unpublished doctoral dissertation, Stanford University.

  4. Adams, G., and V.A. Dzokoto 2002 Perceptions of a Genital-Shrinking outbreak among interview participants in Tamale. Unpublished data. University of Kansas, Lawrence.

  5. 2003 Self and identity in African Studies. Self and Identity 2: 345–359.

    Google Scholar 

  6. Adams, G., and H.R. Markus 2004 Toward a Conception of Culture Suitable for a Social Psychology of Culture. In The Psychological Foundations of Culture. M. Schaller and C. Crandall, eds., pp. 335–360. Mahwah, NJ: Lawrence Erlbaum Associates.

    Google Scholar 

  7. Akyeampong, E.K. 1996 Drink, Power, and Cultural Change: A Social History of Alcohol in Ghana, c.1800 to Recent Times. Portsmouth, NH: Heinemann.

    Google Scholar 

  8. Ameka, F.K. 2002 Cultural Scripting of Body Parts for Emotions: On Jealousy and Related Emotions in Ewe. Pragmatics and Cognition 10: 27–58.

    Google Scholar 

  9. American Psychiatric Association 1994 Diagnostic and Statistical Manual of Mental Disorders. 4th Edition. American Psychiatric Association Press, Washington DC.

    Google Scholar 

  10. Ang, P.C., and M.P.I. Weller 1984 Koro and Psychosis. British Journal of Psychiatry 145: 335.

    PubMed  Google Scholar 

  11. Assimeng, J.M. 1989 Religion and Social Change in West Africa: An Introduction to the Sociology of Religion. Accra, Ghana: Ghana University Press.

    Google Scholar 

  12. Bannerman-Richter, G. 1982 The Practice of Witchcraft in Ghana. Elk Grove, CA: Gabari.

    Google Scholar 

  13. Bartholomew, R.E. 1998 The Medicalization of Exotic Deviance: A Sociological Perspective on Epidemic Koro. Transcultural Psychiatry 35(1): 5–38.

    Google Scholar 

  14. 2001 Little Green Men, Meowing Nuns, and Head-Hunting Panics: A Study of Mass Psychogenic Illness and Social Delusion. Jefferson, NC: McFarland.

    Google Scholar 

  15. Bernstein, R.L., and A. Gaw 1990 Koro: Proposed Classification for the DSM-IV. American Journal of Psychiatry 147: 1670–1674.

    Google Scholar 

  16. Berrios, G.E., and S.J. Morley 1984 Koro-like Symptoms in a Non-Chinese Subject. British Journal of Psychiatry 145: 331–334.

    PubMed  Google Scholar 

  17. British Broadcasting Corporation http://news.bbc.co.uk/hi/English/world/Africa/wesid_1678000/1678996.stm, accessed December 7, 2001

  18. 2001b “Missing” Penis Sparks Mob Lynching. Electronic document, http://news.bbc.co.uk/hi/English/world/Africa/wesid_1274000/1274235.stm, accessed December 7, 2001.

  19. Cable News Network 2003 Suspected Genital Thief Beaten to Death in Gambia. Electronic document, http://www.cnn.com/2003/WORLD/africa/10/09/gambia.penis.reut/, accessed October 12, 2003.

  20. Cheng, S.T. 1996 A Critical Review of Chinese Koro. Culture, Medicine and Psychiatry 20: 67–82.

    Google Scholar 

  21. Chowdhury, A.N. 1993 Glans Penis Perception of Koro patients. Acta Psychiatria Scandinavica, 87: 355–357.

    Google Scholar 

  22. 1994 Koro in Females: An Analysis of 48 Cases. Transcultural Psychiatric Research Review 31(4): 369–380.

    Google Scholar 

  23. 1996 The Definition and Classification of Koro. Culture, Medicine and Psychiatry 20: 41–65.

    Google Scholar 

  24. 1998 Hundred Years of Koro—The History of a Culture-Bound Syndrome. International Journal of Social Psychiatry 44: 174–177.

    Google Scholar 

  25. Ciekawy, D., and P. Geschiere 1998 Containing Witchcraft: Conflicting Scenarios in Postcolonial Africa. African Studies Review 41: 1–14.

    Google Scholar 

  26. Colligan, M.J., and L.R. Murphy 1982 A review of Mass Psychogenic Illness in Work Settings. In Mass Psychogenic Illness: A Social Psychological Analysis. M.J. Colligan, J.W. Pennebaker, and L.R. Murphy, eds., pp. 33–52. Hillsdale, NJ: Lawrence Erlbaum.

    Google Scholar 

  27. Djiwan, H.A., P. Adeniyi, B.B. Biao, and F.H. Nanga 2001 Lynchage de Presumes Voleurs de Sexe: Nouvelles Victimes et les Consequences pour le Benin. Electronic document, http://www.h2.com/lematinal/Archives/011126/mlpolitique2.htm, accessed December 11, 2001.

  28. Dzokoto, V., and S. Okazaki 2003 Happiness as Eye-Get or White Heart: A Comparison of Somatic Referencing in the Emotion Vocabularies of Two West African Languages. Unpublished manuscript, University of Illinois, Urbana-Champaign.

  29. Dzokoto, V., M. Robinson, and M. Tamir 2003 Culture and Somatic-Focused Attention: A Reaction Time Investigation. Unpublished manuscript, University of Illinois, Urbana-Champaign.

  30. Edwards, J.W. 1984 Indigenous Koro, a Genital Retraction Syndrome of Insular Southeast Asia: A Critical Review. Culture, Medicine and Psychiatry 8: 1–24.

    Google Scholar 

  31. Fishbain, D.A., S. Barsky, and M. Goldberg 1989 “Koro” (Genital Retraction Syndrome): Psychotherapeutic Interventions. American Journal of Psychotherapy 43: 87–91.

    PubMed  Google Scholar 

  32. Fortes, M. 1978 Parenthood, Marriage, and Fertility in West Africa. Journal of Development Studies 14: 121–149.

    Google Scholar 

  33. Friedman, S., and C. Paradis 2002 Panic Disorder in African-Americans: Symptomatology and Isolated Sleep Paralysis. Culture, Medicine and Psychiatry 26: 179–198.

    Google Scholar 

  34. Geschiere, P. 1997 The Modernity of Witchcraft: Politics and the Occult in Postcolonial Africa. Charlottesville, VA: University of Virginia Press.

    Google Scholar 

  35. Good, B. J. 1994 Medicine, Rationality, and Experience: An Anthropological Perspective. Cambridge, England: Cambridge University Press.

    Google Scholar 

  36. Goody, J. 1957 Anomie in Ashanti? Africa 27: 356–363.

    Google Scholar 

  37. Guerts, K. L. 2002 Culture and the Senses: Bodily Ways of Knowing in an African Community. Berkeley: University of California Press.

    Google Scholar 

  38. Hesse, R.B.W. 1997 Of Satanic Seals, Ignorance and Superstition. Daily Graphic, January 25: 5.

    Google Scholar 

  39. Hinton, D., C. Hsia, K. Um, and M.W. Otto 2003 Anger-Associated Panic Attacks in Cambodian Refugees with PTSD: A Multiple Baseline Examination of Clinical Data. Behaviour Research & Therapy 41: 647–654.

    Google Scholar 

  40. Holden, T.J. 1987 Koro Syndrome Associated with Alcohol-Induced Systemic Disease in a Zulu. British Journal of Psychiatry 151: 695–697.

    PubMed  Google Scholar 

  41. Hughes, C.C. 1996 The Culture-Bound Syndromes and Psychiatric Diagnosis. In Culture and Psychiatric Diagnosis: A DSM-IV Perspective. J. Mezzich, A. Kleinman, H. Fabrega, Kleinman, H. Fabrega, et al., eds., pp. 298–308. Washington, DC: APA.

    Google Scholar 

  42. Ilechukwu, Sunny T.C. 1992 Magical Penis Loss in Nigeria: Report of a Recent Epidemic of a Koro-like Syndrome. Transcultural Psychiatric Research 29: 91–108.

    Google Scholar 

  43. Jackson, M. 1990 The Man Who Could Turn Into an Elephant: Shape-Shifting Among the Kuranko of Sierra Leone. In Personhood and Agency: The Experience of Self and Other in African Cultures. M. Jackson and I. Karp, eds., pp. 59–78. Uppsala, Sweden: Academiae Upsaliensis.

    Google Scholar 

  44. Jahoda, G. 1970 Supernatural Beliefs and Changing Cognitive Structures Among Ghanaian University Students. Journal of Cross-Cultural Psychology 1: 115–130.

    Google Scholar 

  45. Johnson, D.M. 1945 The “Phantom Anesthetist” of Mattoon: A Field Study of Mass Hysteria. Journal of Abnormal and Social Psychology 40: 175–186.

    Google Scholar 

  46. Kerckhoff, Alan C. 1982 A Social Psychological View of Mass Psychogenic Illness. In Mass Psychogenic Illness: A Social Psychological Analysis. M.J. Colligan, J.W. Pennebaker, and L.R. Murphy, eds., Hillsdale, NJ: Lawrence Erlbaum.

    Google Scholar 

  47. Kerckhoff, A.C., and K.W. Back 1968 The June Bug: A Study of Hysterical Contagion. New York: Appleton-Century-Crofts.

    Google Scholar 

  48. Kirby, J.P. 1986 God, Shrines and Problem Solving Among the Anufo of Northern Ghana. Berlin, Germany: Dietrich Reimer Verlag.

    Google Scholar 

  49. Kleinman, A. 1988 The Illness Narratives. New York: Basic Books.

    Google Scholar 

  50. Kleinman, A., and J. Kleinman 1985 Somatization: The Interconnections in Chinese Society among Culture, Depressive Experiences, and in the Meanings of Pain. In Culture and Depression. A. Kleinman and B. Good, eds., pp. 429–490. University of California Press.

  51. Kovacs, A., and P. Osvath 1998 Genital Retraction Syndrome in a Korean Woman—A case of Koro in Hungary. Psychopathology 31: 220–224.

    Article  PubMed  Google Scholar 

  52. Lewis-Fernández, R., P.J. Guarnaccia, I.E. Martínez, E. Salmán, A. Schmidt, and M. Liebowitz 2002 Comparative Phenomenology of Ataques de Nervios, Panic Attacks, and Panic Disorder. Culture, Medicine and Psychiatry 26: 199–223.

    Google Scholar 

  53. Malinck, C., J.A. Flaherty, and T. Jobe 1985 Koro: How Culturally Specific? The International Journal of Social Psychiatry 31: 7–73.

    Google Scholar 

  54. Markus, H.R., and S. Kitayama 2004 Models of Agency: Sociocultural Diversity in the Construction of Action. In The Nebraska Symposium on Motivation: Cross-Cultural Differences in Perspectives on Self (Vol. 49). V. Murphy-Berman and J. Berman, eds., Lincoln, NE: University of Nebraska Press.

    Google Scholar 

  55. Markus, H.R., P. Mullally, and S. Kitayama 1997 Selfways: Diversity in Modes of Cultural Participation. In U. Neisser and D.A. Jopling, eds., The conceptual self in context: Culture, experience, self-understanding pp. 13–61. Cambridge, UK: Cambridge University Press.

    Google Scholar 

  56. Meyer, B. 1998 The Power of Money: Politics, Occult Forces, and Pentecostalism in Ghana. African Studies Review, 41, 15–37.

    Google Scholar 

  57. Mirror 1997 Genital Shrinking: Do You Believe It? Mirror, January 25: 1.

  58. Modai, I., H. Munitz, and D. Aizenberg 1986 Koro in an Israeli Male. British Journal of Psychiatry 149: 503–505.

    PubMed  Google Scholar 

  59. Mun, C.T. 1968 Epidemic Koro in Singapore. British Medical Journal 1: 640–641.

    Google Scholar 

  60. Nichter, M. 1981 Idioms of Distress: Alternatives in the Expression of Psychosocial Distress. A Case Study from South India. Culture, Medicine and Psychiatry 5: 5–24.

    Google Scholar 

  61. Nigerian Vanguard Online 2001 Panic as Suspected Organ Snatchers Invade Plateau. http://www.vanguardngr.com/news/articles/2001/September/07092001/n4070901.htm, retrieved December 12, 2001.

  62. Nisbett, R.E., K.P. Peng, I. Choi, and A. Norenzayan 2001 Culture and Systems of Thought: Holistic Versus Analytic Cognition. Psychological Review 108: 291–310.

    Article  PubMed  Google Scholar 

  63. Nyinah, J.B. 1997 Sanity Returns to Accra. Daily Graphic, January 20: 8.

    Google Scholar 

  64. Nyinah, J.B., and I. Aboagye 1997 Panic, Drama in Accra. Daily Graphic, January 17: 1, 8.

    Google Scholar 

  65. Owusu, D.A. 1997 Police Can’t Charge Suspects. Ghanaian Times, January 18: 1, 2.

    Google Scholar 

  66. Park, L., and D. Hinton 2002 Dizziness and Panic in China: Associated Sensations of Zang Fu Organ Disequilibrium. Culture, Medicine and Psychiatry 26: 225–257.

    Google Scholar 

  67. Parzen, M.D. 2003 Toward a Culture-Bound Syndrome-Based Insanity Defense? Culture, Medicine and Psychiatry. 27(2) 131–155.

    Google Scholar 

  68. People and Places 1997 Fear Grips Accra. People and Places, 168, January 23–29: 2.

  69. Priestley, C. 2002 Insides and Emotion in Koromu. Pragmatics & Cognition, 10(1/2): 253–281.

    Google Scholar 

  70. Piot, C. 1999 Remotely Global: Village Modernity in West Africa. Chicago: University of Chicago Press.

    Google Scholar 

  71. Riesman, P. 1986 The Person and the Life Cycle in African Social Life and Thought. African Studies Review 29: 71–138.

    Google Scholar 

  72. Sackey, B.M. 1997 The Vanishing Sexual Organ Phenomenon in the Context of Ghanaian Religious Beliefs. African Anthropology 4: 110–124.

    Google Scholar 

  73. Schachter, S., and J.E. Singer 1962 Cognitive, Social, and Physiological Determinants of Emotional State. Psychological Review 69: 379–399.

    PubMed  Google Scholar 

  74. Shaw, R. 2000 “Tok af, lef af”: A Political Economy of Temne Techniques of Secrecy and Self. In African Philosophy as Cultural Inquiry. I. Karp and D.A. Masolo, eds., pp. 25–49. Bloomington, IN: Indiana University Press.

    Google Scholar 

  75. Stein, D.J., M. Frenkel, and E. Hollander 1991 Classification of Koro. American Journal of Psychiatry 148: 1279–1280.

    Google Scholar 

  76. Turpin, M. 2002 Part terms in Kaytetye Feeling Expressions. Pragmatics & Cognition 10(1/2): 283–319.

    Google Scholar 

  77. Trull, D. 1996 Invasion of the Penis Snatchers. http://www.parascope.com/articles/1196/penisw.htm. Electronic document, retrieved October 01, 2003.

  78. Udo, B. 1998 Justice in Service of Community. http://www.postexpresswired.com/news/articles/1998.htm. Electronic document, retrieved November 19, 2000.

  79. Yap, P.M. 1951 Mental Disease Peculiar to Certain Cultures. Journal of Mental Science 97: 313–322.

    PubMed  Google Scholar 

  80. 1965 Koro–A Culture-Bound Depersonalization Syndrome. British Journal of Psychiatry, III: 45–50.

    Google Scholar 

  81. Ye, Z. 2002 Different Modes of Describing Emotions in Chinese: Bodily Changes, Sensations, and Bodily Images. Pragmatics & Cognition 10(1/2): 321–356

    Google Scholar 

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Correspondence to Vivian Afi Dzokoto.

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Dzokoto, V.A., Adams, G. Understanding Genital-Shrinking Epidemics in West Africa: Koro, Juju, or Mass Psychogenic Illness?. Cult Med Psychiatry 29, 53–78 (2005). https://doi.org/10.1007/s11013-005-4623-8

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Keywords

  • culture-bound syndrome
  • West African
  • somatization