The Role of Culture in Treatment of MDD & Phobias (SL IB Psychology)

Collectivist Cultures: an overview

• The Sociocultural Approach (examined on Paper 1) has culture as one of its main areas of focus e.g. culture and its effect on individual behaviour
• One of the key topics in the IB Psychology study of culture is cultural dimensions (which you can find, along with the other Sociocultural topics, on this site)
• The most-studied cultural dimension is the Individualism/Collectivism dimension
• The bulk of the theories and studies that you cover in IB Psychology (and this will apply if you go on to study Psychology at degree level) use research from Western cultures i.e. the USA, the UK, Western Europe, Australia which are all individualistic cultures
• Collectivist cultures can be characterised in the following ways:
  • An emphasis on we/us rather than I/me
  • Priority is given to the group rather than to the individual
  • Cultural norms may centre around behaviours which benefit the family/community/society e.g. living with extended family; sharing earnings with the family or the community as a whole; older people being awarded due respect and status; rituals and ceremonies which celebrate long-established traditions
• Collectivist cultures have been studied alongside individualistic cultures in cross-cultural research with an emphasis on comparison of both cultures on key variables e.g. conformity

Are you a ‘me’ or a ‘we’?

Cultural Relativism

• One of the problems with cross-cultural research is that it may result in universal, ethnocentric or etic conclusions being made i.e. the researcher(s) may (consciously or unconsciously) view their findings through the prism of their own cultural perspective
• Cultural relativism (CR) is the idea that not all cultures are the same and there is no one ‘superior’ culture: diversity should be respected and accounted for in research
• CR emphasises the idea that behaviour should be understood in the context of the culture itself rather than making judgements based purely on the behaviour in question
• Using a CR approach to research involves a lack of judgement of cultures which are different from the cultural norms of whomever is conducting the research
• CR means that a researcher should try to understand cultural practices from within that culture so that instead of making value-judgements about the culture, the researcher asks interested questions e.g. ‘Why is it that latah exists in Malaysia and Indonesia?’ (latah presents as  hypersensitivity to sudden fright, often with echopraxia, echolalia, command obedience, and dissociative or trancelike behaviour)

A zar ritual, designed to cure the person who has been possessed by a spirit.

Culture & mental health

• The topic of clinical biases in diagnosis (which you can find on this site) considers culture-bound-syndromes (CBS), concluding that Western individualistic clinicians who are not familiar with CBS may mis-diagnose mental disorders due to a lack of cultural knowledge 
• Different cultures have different values so trying to apply a universal model of treatment (specifically, the biomedical model with its emphasis on physiological etiology of disorders) across cultures does not account for CR
• Some cultures are wary of disorders such as MDD so their criteria for treating depressive symptoms will be based on their own cultural understanding of the condition rather than on a course of antidepressants
• In Ethiopia there is a CBS known as zar which a Western clinician may treat as MDD (as it involves weeping, apathy, withdrawal, loss of appetite), whilst ignoring the cultural context which is that symptoms are attributed to spirit possession with the possibility of the person developing a long-term relationship with the possessing spirit
• In China there is a CBS known as shenkui which a Western clinician may treat as an anxiety disorder such as phobia (as it involves panic), whilst ignoring the cultural context which is that symptoms are attributed to excessive semen loss from frequent intercourse, masturbation, nocturnal emission i.e. excessive semen loss is feared because it thought to be life-threatening 

Which studies investigate the role of culture in treatment of MDD & phobias?

• Hodge & Nadir (2008) - A review of four therapeutic approaches to treatment of MDD and phobias

• Hinton et al. (2005) - the efficacy of CBT for Cambodian refugees  

Both Hodge & Nadir (2008) and Hinton et al. (2005) are available as Two Key Studies of the Role of Culture in Treatment of MDD & Phobias: just navigate the Treatment of Disorders section to find them