Analysis of Culture-Bound Syndrome - Research Paper Example

?Culture bound syndrome of the syndrome The term culture bound syndrome was initially coined by a psychiatrist - Pow Ming Yap, in the 1960s, based on his observation and studies by other researchers, which described the behavioral syndromes o diseases suffered by locals, which were generally unknown outside their localities. Some researchers have often referred to this syndrome as an 'atypical psychogenic psychoses' (Ember & Ember, 2004). Culture bound syndrome has been defined differently by various authors, to refer to the “'episodic and dramatic reactions specific to a particular community locally defined as discrete patterns of behavior" (Littlewood & Lipsedge, 1985, pp. 109). According to APA's Group on Culture and Diagnosis the term culture bound syndrome "denotes recurrent, locality-specific patterns of aberrant behavior and troubling experience that may or may not be linked to a particular DSM-IV diagnostic category. Many of these patterns are indigenously considered to be 'illnesses', or at least afflictions and most have local names." (Sharma & Atri, 2010, pp. 372). This syndrome usually refers to locally specific patterns of behavior and/ or experiences which fall outside or beyond the purview of what is typically defined as conventional western psychiatric diagnostics. The culture bound syndromes are perceived as illnesses in the regions in which they are found, and have typical regional / local names. For instance, Ataque de Nervios - commonly found in the Latin Americans; Bouffee delirante - among the African and Haitian populace; and obesity among the North Americans are termed and referred to as culture bound syndromes (Cohen, 2011). Prevalence of the syndrome: For the purpose of this study the Ataque de Nervios syndrome, which is a frequently observed mental health issue among the Puerto Ricans and Hispanics, will be studied and discussed at length. Ataques de nervios is a term which is commonly used to describe emotional distress, in the field of psychopathology by the Puerto Ricans and according to statistics its prevalence in Puerto Rico has been estimated to be nearly 14%. The prevalence of this illness is far more frequent and wide spread especially among the patients of mental health (Gherovici, 2003). This illness was first identified and mentioned in research, during the early 1950s by the U.S. military psychiatrists stationed in Puerto Rico (Fernandez-Marina, 1961; Mehlman, 1961; Rubio, Urdaneta, & Doyle, 1955). The American military psychiatrists encountered this illness while treating some of the Puerto Ricans, which was then referred to as the Puerto Rican Syndrome. The name was given due to its unique prevalence among the local population (Fernandez-Marina, 1961; Mehlman, 1961). This illness have been also diagnosed among the American population, but a majority of these cases are restricted to the Hispanics and Lations, in the U.S. According to statistics, this illness has been observed to have over 70% prevalence rates among Hispanic adults (Lewis-Fernandez, Guarnaccia, et al., 2002; Weingartner et al., 2002). How the disorder impacts people According to the DSM-IV-TR, the symptoms of ataques de nervios, vary widely among the population but most of the patients diagnosed with this illness are known to suffer from frequent outbursts of anger, and suffer from uncontrollable rage (APA, 2000). People suffering from this illness, are known to suffer from uncontrollable bouts of anger often resulting in yelling and shouting, crying attacks, violent trembling, heat in the chest rising into the head, followed by verbal as well as physical aggression. Furthermore the individuals may experience seizure like episodes resulting in unconsciousness, which often causes severe distress among the patients, often leading to suicidal tendencies among them. Some people suffering from this illness may also suffer from amnesia, and may forget the events occurred during such an attack, but return to normal once these attacks are over (Edberg, 2012). Perception and impact of this syndrome on the local populace: According to available research on cultural bound syndromes, illnesses falling under this category usually have multiple perspectives with regard to the manner in which they are perceived, treated and described by the local populace. The manner in which such illnesses are defined and treated is specific to these cultures and local groups. The cultures in which these illnesses are commonly observed, find a way to describe them in a manner which the locals are familiar with. The suffering is then described and psycholized, based on experiences and the impact of the suffering is defined in locally relevant terms. The illnesses are hence defined as a result of ‘fate’ or ‘destiny’ and put through a ‘spiritual test’ which is one of the most widely and locally accepted means of treatment (American Psychiatric Association, 1994; Alarcon, Foulks, Vakkur, 1998). Possible causes of the syndrome: Some of the key causes of this illness, include - tragic event witnessed by the patient such as death of a close relative or family member; separation or divorce in the family; conflicts with a spouse or children; witnessing an accident involving family members etc (Sadock & Sadock, 2008). According to a study conducted by a group of researchers, which included interviewing of Latino groups suffering from this illness, it was observed that some of the most common causes of ataque de nervios included - emotional problems, stress at work or at home, alcohol abuse, child abuse, and other intrapsychic conflicts. Furthermore, according to the clinicians who were interviewed as a part of this study, stated biochemical imbalance as one of the key causes of ataque de nervios (Kanel, 2011). How does the culture respond to the syndrome The concept of illness among Latinos, particularly the Hispanics is viewed as originating from 'susto' i.e. fright. Hence the remedies prescribed for the treatment of diseases stem from these cultural beliefs, whereby diseases are treated according to a hot-and-cold theory of disease causation. Ataque de nervios is viewed as a mental health illness originating from stress, according to the Latinos; hence it is treated through the use of various alternative and complementary healing practices which include non-traditional local biomedical treatments. Latinos traditionally are known to maintain a fruit and/or herb garden, where many traditional medicines for healing illnesses are grown. These natural remedies are also sold by religious and spiritual healers, in shops known as botanicas. Methods such as lighting candles and offering prayers, apart from the locally grown herbs, are prescribed as treatment and popularly followed by the populace (Bigby, 2003). Ethical considerations: treatment of such patients in the U.S. The development of public health is directly dependent on the effectiveness of service delivery of the public health systems. This includes ensuring cultural competence, and offering culturally competent and appropriate services to the vast and diverse multi-cultural population in the U.S. The health care professionals must ensure that all individuals must be offered culturally competent and ethical health care services, which highlight the core values such as empathy, warmth and genuineness. References: Alarcon, R. D., Foulks, E. F., Vakkur, M., (1998). Personality disorders and culture: Clinical and conceptual interactions, NY: Wiley publications American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders (4th ed., rev). Washington, DC: Author. American Psychiatric Association, (1994). Diagnostic and statistical manual of mental disorders, fourth edition, Washington, D.C. Bigby, J., (2003). American College of Physicans - Cross-cultural medicine: American Society of Internal Medicine, ACP Press, pp. 72-75 Cohen, L. J., (2011). The handy psychology answer book. Visible Ink Press Edberg, M., (2012). Essentials of health, culture and diversity. Jones & Bartlett Publishers, pp. 43-44 Ember, C. R., Ember, M., (2004). Encyclopedia of medical anthropology: Health and illness in the world's cultures, VOl. 1., Springer Publication. Fernandez-Marina, R. (1961). The Puerto Rican syndrome: Its dynamics and cultural determinants. Psychiatry, 24, pp. 79-82. Gherovici, P., (2003). The Puerto Rican Syndrome. Other Press LLC, pp. 73-74 Kanel, K., (2011). A guide to crisis intervention. Cengage Learning Publication, pp. 106-108 Lewis-Fernandez, R., Guarnaccia, P. J., Martinez, I. E., Salman, E., Schmidt, A., & Liebowitz, M. (2002). Comparative phenomenology of ataques de nervios, panic attacks, and panic disorder. Culture, Medicine and Psychiatry, 26, pp. 199-223. Littlewood & Lipsedge (1985) cited in Sharma, Sharma, M., Atri, A., (2010). Essentials of international health. Jones & Bartlett Learning, Pp. 372-373 Mehlman, R. D. (1961). The Puerto Rican syndrome. American Journal of Psychiatry, 118, pp. 328-332. Rubio, M., Urdaneta, M., & Doyle, J. L. (1955). Psychopathologic reaction patterns in the Antilles command. US Armed Forces Medical Journal, 6, pp. 1767-1772. Sadock, B. J., Sadock, V. A., (2008). Kaplan and Sadok's concise textbook of clinical psychiatry. Lippincott Williams & Wilkins Publishers, pp. 196 Sharma, M., Atri, A., (2010). Essentials of international health. Jones & Bartlett Learning, Pp. 372-373 Weingartner, K., Robison, J., Fogel, D., & Gruman, C. (2002). Depression and substance use in a middle aged and older Puerto Rican population. Journal of Cross-Cultural Gerontology, 17, pp. 173-193. Read More