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Cross-Cultural Psychiatry and Validity in DSM-5

  • Tim Thornton
Chapter

Abstract

The latest edition of the American Psychiatric Association’s Diagnostic and Statistical Manual, DSM-5, explicitly addresses the possibility of cultural variation in mental illness. Among other things, it contains a ‘Glossary of Cultural Concepts of Distress’, which describes nine common conditions, including khyal cap, or ‘wind attacks’, a syndrome found among Cambodians in the United States and Cambodia. The chapter examines three possible models of the relation between such cultural idioms and the ambition, for DSM-5, of being a valid taxonomy of universal forms of mental illness. The models are (1) an underlying universal ‘pathogenic’ component overlain by a variable ‘pathoplastic’ cultural shape, (2) a pathogenic-only model, and (3) a pathoplastic-only model. None, however, reconciles the DSM’s simultaneous ambitions of validity and cultural sensitivity and suggest that the ‘Glossary of Cultural Concepts of Distress’ remains an afterthought in tension with the rest of the taxonomy.

Keywords

Mental Illness Anorexia Nervosa Panic Disorder Panic Attack Pathogenic Factor 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Notes

Acknowledgement

This chapter was written whilst I was a fellow of the Institute for Advanced Study, University of Durham. My thanks to both the IAS, Durham, and the University of Central Lancashire for granting me research leave.

References

  1. American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders fourth edition (DSM-IV). Washington, DC: American Psychiatric Association.Google Scholar
  2. American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders fourth edition text revision (DSM-IV-TR). Washington, DC: American Psychiatric Association.CrossRefGoogle Scholar
  3. American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders fifth edition (DSM-5). Washington, DC: American Psychiatric Association.CrossRefGoogle Scholar
  4. Birnbaum, K. (1974 [1923]). The making of a psychosis—(trans: Marshall, H.). In S. R. Hirsch & M. Shepherd (Eds.), Themes and variations in European psychiatry (pp. 197–238). Bristol: John Wright.Google Scholar
  5. Boorse, C. (1975). On the distinction between disease and illness. Philosophy and Public Affairs, 5, 49–68.Google Scholar
  6. Fulford, K. W. M. (1989). Moral theory and medical practice. Cambridge: Cambridge University Press.Google Scholar
  7. Guarnaccia, P. J., & Rogler, L. H. (1999). Research on culture-bound syndromes: New directions. The American Journal of Psychiatry, 156, 1322–1327.PubMedGoogle Scholar
  8. Hinton, D. E., Pich, V., Marques, L., Nickerson, A., & Pollack, M. H. (2010). Khyal attacks: A key idiom of distress among traumatized Cambodia refugees. Culture, Medicine and Psychiatry, 34, 244–278.CrossRefPubMedGoogle Scholar
  9. Kleinman, A. M. (1977). Depression, somatization and the ‘new cross-cultural psychiatry’. Social Science and Medicine, 11, 3–10.CrossRefPubMedGoogle Scholar
  10. Kupfer, D. J., First, M. B., & Regier, D. A. (Eds.). (2002). A research agenda for DSM–V. Washington, DC: American Psychiatric Association.Google Scholar
  11. Littlewood, R. (1985). The migration of culture-bound syndromes. In E. Pichot (Ed.), Psychiatry the state of the art volume 8 history of psychiatry, national schools, education, and transcultural psychiatry (pp. 703–707). London: Springer.Google Scholar
  12. Littlewood, R. (1986). Russian dolls and Chinese boxes: An anthropological approach to the implicit models of comparative psychiatry. In J. L. Cox (Ed.), Transcultural psychiatry (pp. 37–58). Beckenham: Croom Helm.Google Scholar
  13. Littlewood, R. (1990). From categories to contexts: A decade of the new cross-cultural psychiatry. British Journal of Psychiatry, 156, 308–327.CrossRefPubMedGoogle Scholar
  14. Littlewood, R. (2002). Pathologies of the West. London: Continuum.Google Scholar
  15. Littlewood, R., & Lipsedge, M. (1986). The culture-bound syndromes’ of the dominant culture: Culture, psychopathology and biomedicine. In J. L. Cox (Ed.), Transcultural psychiatry (pp. 253–273). Beckenham: Croom Helm.Google Scholar
  16. Mackie, J. L. (1993). Causes and conditionals. In E. Sosa & M. Tooley (Eds.), Causation (pp. 33–50). Oxford: Oxford University Press.Google Scholar
  17. McDowell, J. (1994). Mind and World. Cambridge: Mass.Google Scholar
  18. Mezzich, J. E., Caracci, G., Fabrega Jr., H., & Kirmayer, L. J. (2009). Cultural formulation guidelines. Transcultural Psychiatry, 46, 383–405.CrossRefPubMedGoogle Scholar
  19. Mezzich, J. E., Kirmayer, L. J., Kleinman, A., Fabrega, H., Parron, D., & Good, B. (1999). The place of culture in DSM-IV. Journal of Nervous and Mental Disease, 187, 457–464.CrossRefPubMedGoogle Scholar
  20. Sass, L. A. (1992). Madness and modernism. New York: Cornell.Google Scholar
  21. Sass, L. A. (1994). The paradoxes of delusion. New York: Cornell.Google Scholar
  22. Wakefield, J. C. (1999). Mental disorder as a black box essentialist concept. Journal of Abnormal Psychology, 108, 465–472.CrossRefPubMedGoogle Scholar

Copyright information

© The Author(s) 2017

Authors and Affiliations

  • Tim Thornton
    • 1
  1. 1.College of Health and WellbeingUniversity of Central LancashirePrestonUK

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