Anthropology and Cross-Cultural

Psychiatry
By: Rother Jan B. Delos Santos
• Anthropology - study of human beings

• Cultural Psychiatry - the definition of culture,

interaction between it and the individual,
culture-specific syndromes, and cross-cultural
differences in definitions of health, illness, and
healing.
 Nature and nurture controversy
• which aspects of human beings are innate
biological
• which aspects are shaped by the environment
• how the constant feedback between these
two aspects affects human beings.
• In psychiatry, the increasingly acknowledged
evidence of biological factors has altered the
view of persons as largely determined by the
outcome of relationships shaping children's
earliest years.
 Psychoanalytical Theory
• Sigmund Freud – (Totem and Taboo) “earliest
humans as a group of brothers who killed and
devoured their violent primal father. This
criminal act and the so-called totem meal
made the brothers feel guilty”.
• rules were formulated, the beginning of social
organization.
• Carl Gustav Jung – (Symbols and
Transformations)
• archaeology and mythology
• patients' fantasies back to earliest human
artifacts.
 Erik Erikson
• Psychocultural biographies of Mohandas
Gandhi and Martin Luther.
• Childhood and Society (1950) -attempted to
integrate individual psychosexual
development with cultural influences.
 George Devereux
• Native Americans
• insights into the problems that arise in dealing
with patients from diverse ethnic
backgrounds.
 Abraham Kardiner
• concept of national character and suggested
that each culture is associated with a common
(or at least widely shared) personality
structure.
• adult Russian personality = depressive and
manic traits
 Ruth Benedict
• Patterns of Culture
• personality types may reflect a culture's
configuration because people are malleable
and they assume society's expected behavior
pattern.
 Bronislaw Malinowski and Margaret
Mead
• adult personality and mental functioning are
largely determined during childhood
• Trobriand Islanders - no evidence of the
Oedipus complex
• Three tribes in New Guinea - different
patterns of sex-role behavior for men and
women in each tribe.
• Deviance created by either condoning or
condemning certain behavior patterns.
• in all societies adults are involved in the
growing child's sexual attitudes, especially
those toward the parent of the opposite sex.
 Margaret Mead
• Coming of Age in Samoa (1928)
• adolescent turmoil are widely believed at the
time to be Universal and appeared not to
exist.
• unusual Samoan culture that nurtured open,
nonpossessive sexual relationships among
adolescents, encouraged communal child
rearing, and denigrated aggressiveness and
competitiveness.
• Rather than an idyllic paradise of free love among
gentle people, most observers, including Samoans
themselves, describe a competitive society marked
by interfamily and inter-village networks in which
female virginity is highly prized at the time of
marriage.
 Psychosocial Growth
• effects of early life experiences on adult
mental health and the explanations for
deviance or maladaptive behavior are still
controversial issues
• historical data about adverse experiences are
used.
• affection-deprived children described by John
Bowlby were able to grow up capable of
forming attachments if condition are favorable
• Freud postulated a universal sequence of
emotional development.
• never found empirical support in crosscultural
studies of human behavioral psychological
development
• well-established cross-cultural universals of
psychosocial development:
1. emergence of sociality - social smiling (1st 4
months of life), maturation of basal ganglia
and cortical motor circuits.
2. Emergence of strong attachments, awareness
of separation, and recognition of strangers –
2nd half of 1st year of life = mat. major fiber
tracts of the limbic system
3. emergence of language – 2nd year and after =
mat. thalamic projection to the auditory
cortex among other circuits
4. emergence of a sex difference in physical
aggressiveness - early and middle childhood,
male more aggressive = prenatal
androgenization of the hypothalamus
5. emergence of adult sexual motivation and
functioning – adolescent = mat.
hypothalamicpituitary-gonadal axis at
puberty
• Factors affecting psychological development
1. Environment
2. Genetics
3. Family relationship
Universal Behaviors:
1. Moro reflex -all normal neonates
2. Ejaculatory motor action - all post pubertal
males
Universal Culture:
1. taboos against incest and homicide
2. institution of marriage
3. social construction of illness and attempts at
healing
 Cross-Cultural Diagnosis
• Jane Murphy and Alexander Leighton
• incidence of psychiatric disorders cross-
culturally

1. both the general category of psychological

deviance and at least several major
syndromes appear to be characteristic of all
cultures for which information is available;
2. some psychiatric disorders appear to be
relatively or largely culture-specific
3. extremely difficult, if not impossible, to
compare incidence or prevalence of most
disorders cross-culturally.
 Medical Anthropology
• The sick role, whether in relation to
psychological or physical illness, occurs in all
cultures, but carries many different meanings
and expectations.
 Cross-Cultural Psychiatry
1. psychological anthropology - using
psychodynamic and other psychological
theory to interpret the relationship among
elements of society and culture.
2. comparative psychiatry - using formal
epidemiological or less formal observational
and clinical methods to describe and analyze
cross-cultural variations in incidence or
prevalence of syndromes and symptoms
3. medical anthropology - using traditional
anthropological methods to elucidate cross-
cultural variation in the social and cultural
construction of illness from disease, and in
the elaboration of healing or care-taking
roles and relationships.
 Diagnostic and Statistical Manual of
Mental Disorders (DSM-IVTR)
• outline for a cultural formulation designed to
assist in the systematic evolution and treatment
of patients.
1. the cultural identity of the patients, including
ethnicity, involvement with original and host
cultures, and language abilities
2. the cultural explanations and idioms of distress
used by patients and their community
concerning their illness or situation
3. the cultural factors impacting patients' social
situations, including work, religion, and kin
networks.
4. the cultural and social status differences
between the patient and clinician that may
affect assessment and treatment, including
problems with communicating, negotiating a
patient and clinician relationship, and
distinguishing between normal and
pathological behaviors
5. formulation of an overall cultural assessment
for diagnosis and care.
 Definitions and Key Concepts
• Culture is a vast, complex concept that is used
to encompass the behavior patterns and
lifestyle of a society and a group of persons
sharing a self-sufficient system of action that
is capable of existing longer than the life span
of an individual and whose adherents are
recruited, at least in part, by the sexual
reproduction of the group members.
• Scope of Culture
• George P. Murdock - noted American
anthropologist
• athletic sports, bodily adornment, calendar,
cleanliness training, community organization,
cooking, cooperative labor, cosmology,
courtship, dancing, decorative art
• Race and Ethnicity
• Race denotes human groupings that are
biologically (and, in theory, genetically)
determined.
• Ethnicity - a term increasingly preferred by
cross-culturalresearchers, connotes groups of
individuals sharing a sense ofcommon
identity, a common ancestry, and shared
beliefs and history.
• Culture and Psychopathology

• Culture is an all-pervasive medium for

humans. It is driven by the human brain's
unique ability to create images and symbols
and structure them into complex wholes that,
in turn, can drive brain function to produce
defined behaviors and modulate instinctually
driven ones.
• Cultural Identity
• in assessing an individual's cultural identity,
clinicians should denote the individual's ethnic
or cultural reference group.
• 3 major sources of stress in the migration
experience:
1. entry into the host society, frequently at
lower occupational and social levels
2. disruption of interpersonal relationships
3. the acculturation process.
• Culture-Bound Syndromes
• Extreme diversity is seen among the peoples
of the world concerning the recognition,
classification, and understanding of mental
behavior symptoms.