ANTH 5360

World Mental Health

 

Course Goals

1. To foster a dialogue and mutual understanding between those in the social sciences and those in the biomedical sciences.  For this reason, I hope that there will be a good deal of fruitful discussion and examination of issues
2. To examine the complex interrelationship between mental illness and culture.  Therefore, key issues in this area will be examined in varying degrees of depth and brought to life.  For this reason, I plan to use films as a central devise for conveying to those in the social sciences the reality of the suffering for those with mental illness and to those in biomedicine that there are perspectives and world views beyond those of the West.
3. To learn more about the relation between culture and mind and brain/body through the understanding of mental illness.  This is a loftier goal, but I believe that through an understanding of these conditions, insights may be gained into this larger issue

Course Requirements

1) Class Participation (approximately 15% of the grade). 

2) Write 8 - 2 page papers discussing the reading of the week, based on the "Questions to Guide Your Reading" for each week.If I get them by Tuesday morning I will try and get feedback to you.  To get credit I have to have them by noon on Wednesday.  (This is 40% of the grade, or 5% each).

3) Attend rounds on the Psychiatry Unit with Dr. Bashir.  Write a 4 to 5 page paper on your observations.  (10% of grade)

4) 15 to 20 page final paper -- a Cultural Assessment. (35%).  We will talk about this in class and there are readings about it and examples in the Resources Section.

 

My office hours are from 10:00 to 12:00 on Mondays.  I will send you a map to my office in the "Old Hospital."  It is on the 3rd floor of the Multistory Building - West Complex, in the suite of Psychiatry Department offices.  My phone there is 924-2241.

 

 

 

 

 

 

Course Syllabus

 

 

 

 

 

 

 

1/15/14 Introduction and Overview of Course: What are the central issues?  There is an increasing realization of the burden of mental illness in the world and the lack of services, from the perspective of western medicine.  There are many factors resulting in this conclusion.  There is also recognition that the application of western style psychiatric diagnosis and treatment models in non-western populations is fraught with difficulty. Furthermore, modern western psychiatry is not consistent in its approach, there being at least two, often conflicting, approaches – one emphasizing biology and the other interpersonal relations and context.  The following articles explore these issues and set the stage for the more detailed discussion of these issues that follows in the ensuing weeks.

Questions to guide your reading:

1)What are the possible causes of increased mental illness, specifically depression, throughout the world today?

2) What are the potential difficulties in making the assumption that there is an increase in depression worldwide?

3) What are the barriers to treatment of mental illness/depression worldwide?

Desjarlais, R. et al., 1995 Chapter 1: The Global Context of Well-Being, World Mental

            Health: Problems and Priorities in Low-Income Countries. New York: Oxford

            University Press: 15-33.

Kirmayer, L. J. and Minas, H. 2000. The Future of Cultural Psychiatry: An International

            Perspective, Can. J. of Psychiatry. 45(5): 438-446.

Kleinman, A. 2012 Medical Anthropology and Mental Health, in MC Inhorn and EA Wentzell (eds.) Medical Anthropology at the Intersections.

           Durham, NC: Duke Univ Press. 116-128.

Lopez, AD; Mathers, CD, et al.,  2006 Global Burden of Disease and Risk Factors.

            Oxford U. Press. And the World Bank. (This is a set of charts and diagrams

            depicting the burden of world mental health issues)

Saxena, S. et al. 2007 Resources for Mental Health: Scarcity, Inequity, and Inefficiency, The Lancet. 370: 878-889.

Wang, PS, et al., Use of Mental Health Services for Anxiety, Mood, and Substance

            Disorders in 17 Countries in the WHO World Mental Health Surveys, Lancet.

            370: 841-850.

Watters, E. 2010 The Americanization of Mental Illness, The New York Times. Jan. 10.

 

1/22/14 Psychiatric/Epidemiological versus Ethnographic/Cultural Perspectives.  This section further explores the basic psychiatric and cultural models of mental illness, as well as some theoretical efforts to bridge the two perspectives.

Questions to guide your reading:

1) What are the advantages and disadvantages of a biomedical approach to sickness?

2) What role does subjectivity plan in a biomedical versus an anthropological approach to sickness?

3) What are the advantages and disadvantages of a cultural/phenomenological approach to sickness?

                        Movie: N/um tchai: The Ceremonial Dance of the !Kung Bushmen

Readings:

Biehl, J. and A. Moran-Thomas 2009 Symptom: Subjectivities, Social Ills, Technologies, Annual Rev. Anthropology. 38: 267-288.

Canino, G. and Alegria, M. 2008 Psychiatric Diagnosis -- Is it universal of relative to culture? J. of Child Psychology and Psychiatry. 49(3): 237-250.

Castillo, R.J. 1996 Chapter 1: Why Culture?, Culture and Mental Illness: A Client-

Centered Approach. Pacific Grove, Ca: Brooks/Cole Publ. C.: 3-24.

Choudhury, S. and Kirmayer, LJ 2009 Cultural Neuroscience and Psychopathology: Prospects for Cultural Psychiatry, Progress in Brain Research. 178: 263-283.

Hollan, D. 2004 Self Systems, Cultural Idioms of Distress, and the Psycho-Bodily

            Consequences of Childhood Suffering, Transcultural Psychiatry. 41(1): 62-79.

 Folmar, S and Palmes, G.K. 2009 Cross-Cultural Psychiatry in the Field: Collaborating

            With Anthropology, J. Am. Acad. Child Adolesc. Psychiatry. 48(9): 873-876.

Kleinman, A. and Kleinman, J. 1991 Suffering and Its Professional Transformation:

Toward and Ethnography of Interpersonal Experience, Culture, Medicine, and

Psychiatry. 15(3): 275-302.

Rosenberg, CE 2002 The Tyranny of Diagnosis: Specific Entities and Individual Experience, The Milbank Quarterly. 80(2): 237-260.

1/29/14 Racism, Stigma, and Mental Illness. The purpose of this section is to explore the relationship between the socio-cultural context and the construction of mental illness.  The readings propose that there is a two-way connection between the onset and manifestation of a mental illness and the sociocultural context in which it occurs.  Furthermore, that the practice of psychiatry and other mental health specialties also occur within, are influenced by, and influence the sociocultural context.

Questions to guide your reading:

1) In what ways does Racism impact on mental health?

2) How does Racism, as an example of Structural Violence, combine with other types of Structural Violence, such as poverty and stigma, to impact mental health?

3) How is Racism an example of culture?

Blow, FC, et al, 2004 Ethnicity and Diagnostic Patterns in Veteran with Psychoses, Soc.

            Psychiatry Psychiatr. Epidemiol. 39: 841-851.

Diaz, FJ and de Leon, J. 2002 Excessive Antipsychotic Dosing in 2 US State Hospitals, J. Clin. Psychiatry. 63: 998-1003.

Fernando, S. 2003 Chpt. 1 – Racism and Cultural Diversity,  in Cultural Diversity, Mental Health and Psychiatry: The Struggle

Against Racism. Hove: Brunner-Routledge: 11-45.

Kendrick, L; Anderson, NLR; Moore, B. 2007 Perceptions of Depression Among Young

            African American men, Fam. Community Health 30(1): 63-73.

Metzl, JM. 2009 Preface, in The Protest Psychosis: How Schizophrenia Became a Black Disease. Boston: Beacon Press: ix-xxi.

Strakowski, SM, et al., 2003 Ethnicity and Diagnosis in Patients With Affective

            Disorders, J. Clin Psychiatry. 64(7): 747-754.

  

2/05/14 Schizophrenia – Biomedical Model and Ethnographic Descriptions.  Part I – Cultural Factors in Outcome

 Schizophrenia is one of the most dreaded of mental illnesses, being synonymous with madness.  In modern psychiatry it represents an example of biologically based illness. We will examine the relationship between the biomedical understanding and sociocultural variation in outcome.

Questions to guide your reading:

1. What are the sociocultural factors that seem to alter the course and prognosis of Schizophrenia?
2. What do these factors say about the emphasis in treatment?
3. Is it possible to develop an understanding of Schizophrenia that includes both biological and sociocultural perspectives?

 

                        Movie: The Brain: Madness

Readings:

Cantor-Graae, E and Selten, JP 2005 Schizophrenia and Migration: A Meta-Analysis and

            Review, Amer. J. of Psychiatry. 162(1): 12-24.

Cohen, BJ. 2003 Chapter 8: Schizophrenia and Other Psychotic Disorders, Theory and

Practice of Psychiatry. New York: Oxford University Press: 206-2228.

Jenkins, J.H. 1988 Conceptions of Schizophrenia as a Problem of Nerves: A Cross-

Cultural Comparison of Mexican-Americans and Anglo-Americans, Social

Science and Medicine. 26(12): 1233-1243.

Kelly, BD 2005 Structural Violence and Schizophrenia, Social Science and Med. 61: 721-730.

Myers, NL 2011 Update: Schizophrenia Across Cultures, Current Psychiatry Rep. 13:

            305-311.

Sharpley, M., et al. 2001 Understanding the Excess of Psychosis Among the African-

Caribbean Population in England, British J. of Psychiatry. 178 (Suppl. 40): s60-

68.

Weisman, A.G. 1997 Understanding Cross-Cultural Prognostic Variability for

Schizophrenia, Cultural Diversity and Mental Health. 3(1): 23-35.

 

2/12/14 Schizophrenia – Biomedical Model and Ethnographic Descriptions. Part II – Subjective Experience

As seen last week the outcome of Schizophrenia is highly variable.  The subjective experience of this condition may play an important role in the course and outcome of this condition.  We will look at a number of personal experiences of schizophrenia and how these vary between settings,

Questions to guide readings:

1. How are these individual descriptions of this disorder similar and different?
2. What role does culture seem to play in the subjective experience of this disorder?
3. What role does the subjective experience play in the overall course and outcome of the condition?

Barrett, R.J. 1997 Cultural Formulation of Psychiatric Diagnosis: Silat Gila in an Iban

Longhouse: Chronic Schizophrenia, Culture, Medicine, and Psychiatry. 21: 365-

379.

Estroff, SE. 1989 Self, Identity, and Subjective experiences of Schizophrenia: in Search

            of the Subject, Schizophrenia Bulletin. 15(2): 189-196.

Geller, JL and Harris, M 1994 Catherine Beecher in Women of the Asylum: Voices from Behinf the

            Walls, 1840-1945. New York: Double Day, 42-46

Goddard, M. 1998 What Makes Hari Run? The Social Construction of Madness in a

Highland Papua New Guinea Society, Critique of Anthropology. 18(1): 61-81.

King, C. 2007 They Diagnosed me a Schizophrenic when I was just a Gemini. “the Other Side of

            Madness,” in Reconceiving Schizophrenia. M Chung, K Fulford and G Graham (eds.) Oxford:

            Oxford University Press. 11-28.

Metzl, JM. 2009 Homocidal, in The Protest Psychosis: How Schizophrenia Became a Black Disease.

            Boston: Beacon Press: 3-5.

Myers, Neely 2012 Toward an Applied Neuroanthropology of Psychosis: The Interplay of Culture,

            Brains, and Experience, Annals of Anthropological Practice. 36(1): 113-130.

 

2/19/14 Post Traumatic Stress Disorder, Refugees, and War. PTSD is the quintessential environmentally caused mental illness.  We will examine the limits of this concept and the cultural variability of experience. 

                        Movie: Rain in a Dry Land

Questions to guide your reading:

1) PTSD is the only psychiatric disorder (DSM 5) where a specific etiological element is recognized - trauma - yet what constitutes trauma is highly debated.  What role does the cultural variation in the conception of what is trauma play in the incidence, course and prognosis of the disorder?

2) There has always been an emphasis on the role of "a" traumatic experience, yet for many  in the world it is a question of multiple traumas, or even a traumatic/trauma filled existence.  How might this influence the nature of PTSD?

3) How is PTSD as a "model" for understanding the role of the environment in psychopathology differ from the "model" for Schizophrenia as the result of biological and cultural factors that we developed in the past sessions?

Readings:

Baker, A and Shalhoub-Kervorkian, N. 1999 Effects of Political and Military Traumas on

Children: The Palestinian Case, Clinical Psychology Review. 19(8): 935-950.

Cohen, BJ. 2003 Chapter 9: Anxiety Disorders—Post Traumatic Stress Disorder, Theory

and Practice of Psychiatry. New York: Oxford University Press: 273-280.

Gustafsson, ML. 2007 The Living and the Lost: War and Possession in Vietnam,

            Anthropology of Consciousness. 18(2): 56-73.

Jenkins, J. H. 1991 The State Construction of Affect: Political Ethos and Mental Health

Among Salvadoran Refugees, Culture, Medicine and Psychiatry. 15(2): 139-165.

Kohrt, BA and Hruschka, DJ. 2010 Nepali Concepts of Psychological trauma: The Role

of Idioms of Distress, Ethnopsychology and Ethnophysiology in Alleviating

Suffering and Preventing Stigma, Cult. Med. Psychiatry. 34: 322-352.

Manson, S. M. 1996 The Wounded Spirit: A Cultural Formulation of Post-Traumatic

Stress Disorder, Culture, Medicine and Psychiatry. 20(4): 489-498.

 

2/26/14 Culture Bound Syndromes I – General introduction and history of the concept, controversies.  Latah and Ataque de Nervios are two famous examples, which have been fairly well studied.  We will examine these as examples of the various controversies which surround this desgniation of “Culture Bound,” representing a model seemingly quite different from that of Schizophrenia and PTSD.    

                        Movie: Latah, a Culturally Structured Startle Response

Questions to guide your reading:

1)  What is a "syndrome" and how is it different from a "disease," an "illness," a "disorder," and "distress"?

2) What is the difference between a "Culture Bound Syndrome" and an "Idiom of Distress"?

3) What do these conditions have in common?

4) Are there western "Culture Bound Syndromes"?

 

Readings:

Bartholomew, R.E. 1994 Disease, Disorder, or Deception?, Latah as Habit in a Malay

Extended Family, The J. of Nervous and Mental Disease. 182: 331-338.

Browne, K. (Ng)amuk Revisited: Emotional Expression and Mental Illness in Central

Java, Indonesia, Transcultural Psychiatry. 38(2): 147-165.

Guarnaccia, P.J. et al. 1989 The Multiple Meanings of Ataques de Nervios in the Latino

Community, Medical Anthropology. 11(1): 47-62.

Guarnaccia, P.J. et al. (1996) The Experiences of Ataques de Nervios: Towards an

Anthropology of Emotions in Puerto Rico, Culture, Medicine and Psychiatry.

20(3): 343-367.

Lewis-Fernandez, R. et al. 2010 Association of Trauma-Related Disorders and

            Dissociation with Four Idioms of Distress Among Latino Psychiatric Outpatients,

            Cult. Med. Psychiatry. 34:219-243.

Littlewood, R. and Lipsedge, M. 1987 The Butterfly and the Serpent: Culture,

Psychopathology and Biomedicine, Culture, Medicine and Psychiatry. 11(3): 289-

336.

 

3/05/14 Culture Bound Syndromes II –Anorexia Nervosa.  Anorexia Nervosa is sometimes seen as a Western example of a Culture Bound Syndrome.  However, it prevalence is now world wide.  How do we understand this development and this condition from a cultural and biological perspective?

                        Movie: Dying to be Thin

Questions to guide your reading:

1) Which term best categorizes Anorexia Nervosa: "Culture Bound Syndrome," "Idiom of Distress," "Culture Change Syndrome," "Body Disatisfaction Syndrome," or "Womens' Powerlessness Syndrome"?

2) How does Anorexia Nervosa differ between the US, Japan, and Fiji? How is it similar?

3) What role does a culture's conception of a person's body play in eating disorders and does this vary between cultures?

Readings:

Becker, AE. 2004 Television, Disordered eating, and Young Women in Fiji: Negotiating

Body image and Identity During rapid Social change, Cult. Med. Psychiatry. 28:

533-559.

Holmqvist, K. and Frisen, A. 2010 Body dissatisfaction Across Cultures: Findings and

            Research Problems, Eur. Eat. Disorders Rev. 18: 133-146.

Katzman, MA and Lee, S. 1997 Beyond Body image: The Integration of Feminist and

Transcultural Theories in the Understanding of Self Starvation, Int. J. of Eating

Disord. 22; 385-394.

Miller, M.N. and Pumariega, A.J. 2001 Culture and Eating Disorders: A Historical and

Cross-Cultural Review, Psychiatry. 64(2): 93-110.

Pike, KM and Borovoy, A. 2004 The Rise of eating Disorders in Japan: Issues of Culture

and Limitations of the Model of “Westernization,” Cult. Med. Psychiatry. 28:

493-531.

3/12/14            Spring Break

 

3/19/14 Dissociative Disorders and Trance: Pathology versus Adaptation. Dissociative Disorders are considered rare in the West, yet in much of the world dissociation is not seen as pathological and may even be highly valued.

                        Movie: Thaipusan, A Hindu Festival

Questions to guide your reading:

1) What is dissociation from a neuropsychological, psychological, anthropological, and a spiritual perspective? How do these perspectives overlap and how do they differ?

2) Why would the western model of the mind consider dissociative states as primarily pathological?

3) What does ritualized dissociation say about the link between dissociation and trauma?

Readings:

Castillo, R. J. 2003 Trance, Functional Psychosis, and Culture, Psychiatry. 66(1): 9-21.

Katz, R. 1982 Accepting “Boiling Energy”: The Experience of !kia-Healing Among the

!Kung, Ethos. 10(4): 344-368.

Krippner, S. 1987 Cross-Cultural Approaches to Multiple Personality Disorder: Practices

in Brazilian Spiritism, Ethos. 15(3): 273-295.

Lester, R.J.  2008 Anxious Bliss: A Case Study of Dissociation in a Mexican Nun, Transcultural

            Psychiatry. 45(1): 56-78.

Luhrmann, TM; Nusbaum, H.; and Thisted, R. 2010 the Absorption Hypothesis: Learning to hear God

            in Evangelical Christianity, American Anthropologist. 112(1): 66-78.

Seligman, R and Kirmayer,  LJ 2008 Dissociative Experience and Cultural Neuroscience: Narrative,

            Metaphor and Mechanism, Culture, Medicine, and Psychiatry.32: 31-64.

 

 3/26/14 Anxiety Disorders: Social Phobia and Taijin Kyofusho. Anxiety is a normal, universal experience, but it is understood differently and this impacts upon when anxiety is and is not a problem.

                        Movie: To be determined

Questions to guide your reading:

1) If anxiety is an essential emotional state, how and when does it become pathological?

2) What does the cross-cultural variation in the somatic symptoms of anxiety tell us about "human nature?"

3) How does the variation between individually and group focused cultures affect the manifestations of anxiety?

Readings:

Barrett, R.J. 1997 Cultural Formulation of Psychiatric Diagnosis: Death on a Horse’s

Back: Adjustment Disorder with Panic Attacks, Culture, Medicine, and

Psychiatry. 21: 481-496.

Hinton, DE, Hinton, L. et al. 2007 Orthostatic Panic Attacks Among Vietnamese

            Refugees, Transcultural Psychiatry. 44(4): 515-544.

Hofman, SG, Asnaani, A, Hinton, DE 2010 Cultural aspects in Social Anxiety and Social

            Anxiety Disorder, Depression and Anxiety. 27: 1117-1127.

Lane, C. 2007. Chapter 1 – The Hundred Years’ war over Anxiety, Shyness: How

Normal Behavior Became a Sickness. New Haven: Yale Univ. Press.

Lock, M. 1986 Plea For Acceptance: School Refusal Syndrome in Japan, Soc. Sci. and Med. 23(2):

            99-112.

Schreier, SS; Heinrichs, N.; et al. 2010 Social anxiety and Social Norms in Individualistic

            and Collectivistic Countries, Depression and Anxiety. 27: 1128-1134.

Udomratn, P and Hinton, DE. 2009 Gendered Panic in Southern Thailand, in DE Hinton

and BJ Good (eds). Culture and Panic Disorder. Stanford, Ca.: Stanford Univ. Press.

 

4/02/14 Depression and Somatization.  Trying to understand depression from an anthropological perspective raises fundamental questions about the western perspective on mental illness.

Movie: Despair

Questions to guide your reading:

1) Is depression, as defined in DSM 5, universal?

2) Making a distinction between depression and somatization speaks to the heart of the western tendency to distinguish between physical and mental illnesses.  What is the consequence of doing this and why does it happen?

3) Is there a universally common aspect of these various "depressive" states?

 

Readings:

Cohen, KS. 2008 at the Canyon’s Edge: Depression in American Indian Culture, Explore.

            4(2): 127- 135.

Manson, S.M., et al. 1985 The Depressive Experience in American Indian Communities:

A Challenge for Psychiatric Theory and Diagnosis, in A. Kleinman and B. Good

(eds.) Culture and Depression: Studies in the Anthropology and Cross-Cultural

Psychiatry of Affect and Disorder. Berkeley: Univ. of Calif. Press: 331-368.

O’Nell, T.D. 1998 Cultural Formulation of Psychiatric Diagnosis: Psychotic Depression

and Alcoholism in an American Indian Man, Culture, Medicine and Psychiatry.

22: 123-136.

Good, BJ 1977 The Heart of What’s the Matter: The Semantics of Illness in Iran, Culture,

            Medicine, and Psychiatry. 1: 25-58.

Kirmayer, LJ, Groleau, D. et al. 2004 Explaining Medically Unexplained Symptoms,

            Can. J. Psychiatry. 49(10): 663-672.

Kirmayer, LJ, and Sartorius, N. 2007. Cultural Models and Somatic Symptoms,

            Psychosomatic Medicine. 69: 832-80.

 

4/09/14 Suicide and Culture. Modern social sciences originally tied suicide to qualitative aspects of culture, yet much of the evidence in the west has been on trying to predict and prevent individual suicides.  The rate, method, demographics, understanding of, and response to suicide varies between cultures. 

                        Movie: Till Death Do Us Part

Questions fo guide your reading:

1) Is suicide always pathological?

2) How does it vary between cultures?

3) What does the cultural construction of suicide say about a culture?

Readings:

Booth, H. 1999 Pacific Island Suicide in Comparative Perspective, J. of Biosocial

Science. 31(4): 433-48.

Counts, D.A. 1993 The Fist, the Stick, and the Bottle of Bleach: Wife Bashing and

Female Suicide in a Papua New guinea Society, in V.S. Lockwood, et al. (eds)

Contemporary Pacific Societies: Studies in Development and Change. Englewood

Cliffs, NJ: Prentice Hall: 249-259.

Desjarlais, R. et al. 1995 Chapter 3: Suicide, World Mental Health: Problems and

Priorities in Low-Income Countries. New York: Oxford University Press: 68-86.

Kitanaka, J. 2008. Diagnosing Suicides of Resolve: Psychiatric Practice in

            Contemporary Japan,  Culture, Medicine, and Psychiatry. 32: 152-176.

Ozawa-de Silva, C. 2008 Too Lonely to Die Alone: Internet Suicide Pacts and Existential Suffering in

            Japan, Clt., Med. and Psych. 32: 516-551

Phillips, M.R., et al. 1999 Suicide and Social Change in China, Culture, medicine and

Psychiatry. 23: 25-50.

 

4/16/14 World Mental Health and the Pharmaceutical Industry. The concept of drug or medication use in the face of suffering assumes a biological conception of suffering. 

Questions to guide your reading:

1) What is the role of this multibillion dollar industry in the shaping of mental illness and the approaches to it?

2) Pharma can be considered an example of globalization, so how do local versus global factors play-out around the use of drugs ?

3) What factors balance the influence and power of Pharma.?

Readings:

Applbaum, K. (2007) Educating for Global Mental Health: The Adoption of SSRIs in

Japan, in Petryna, A; Lakoff, A.; and Kleinman, A. (eds). Global Pharmaceuticals:

Ethics, Markets, Practices. Durham, N.C.: Duke Univ. Press: 85-110.

Fournier, JC; DeRubeis, RJ; et al. 2010. Antidepressant Drug Effects and Depression

            Severity: A Patient-Level Meta-analysis, JAMA. 303(1): 47-53.

Fox, NJ. And Ward, KJ. 2009 Pharma in the Bedroom…and the kitchen… The

Pharmaceuticalisation of Daily Life, in SJ Williams, J Gabe, and P. Davis (eds).

Pharmaceuticals and Society: Critical Discourses and Debates. Malden, MA:

Wiley-Blackwell: 41-53.

Kirmayer, L.J. (2002) Psychopharmacology in a Globalizing World: The Use of

            Antidepressants in Japan, Transcultural Psychiatry. 39(3): 295-322.

Landefeld, C.S. and Steinman, M.A. 2009 The Neurontin Legacy—Marketing through

Misinformation and Manipulation, NEJM. 360(2): 103-106.

Petryna, A. 2005 Ethical Variability: Drug Development and Globalizing Clinical Trials, American

            Ethnologist. 32(2): 183-197.

Schermer, MHN 2007 Brave New World versus Island – Utopian and Dystopian Views

of  Psychopharmacology, Medicine, health Care and Philosophy. 10: 119-128.

Spielmans, GI and Parry, PI. 2010 From Evidence-based medicine to Marketing-based

Medicine: Evidence from Internal Industry Documents, Bioethical Inquiry. January 21:

Turner, EH, Matthews, AM. Et al. 2008. Selective Publication of Antidepressant Trials

            and Its Influence on Apparent Efficacy, NEJM. 358(3): 252-

 

4/23/14 World Mental Health and Treatment Models. The treatment of illness says a lot about the conceptions that underlie a culture’s understanding of mental illness, which in turn impacts the outcome of treatment.

                        Movie: N’kpiti = Spite

Questions to guide your reading:

1) How do Explanatory Models or Idioms of Distress relate to treatment strategies?

2) Can the efficacy of indigenous treatments be understood and demonstraed within a Western scientific paradigm?

3) If "mental illness" or social suffering in part relate to a person's connection with their local world, what does this say about how treatment should be oriented?

 

 

Reading:

Diaz, E., Fergusson, A., and Strauss, JS 2004 Innovative Care for the Homeless Mentally

Ill in Bogota, Columbia, in JH Jenkins and RJ Barrett (eds) Schizophrenia,

Culture, and Subjectivity. Boston, MA: Cambridge Unive. Press: 219-

Kleinman, A. and Sung, LH. 1979 Why Do Indigenous Practitioners Successfully Heal?

            Soc. Sci. and Med. 138: 7-26.

Martinez-Taboas, A. 1999 A Case of Spirit Possession and Glossolalia, , Culture,

Medicine, and Psychiatry. 23: 333-348.

Myers, NL. 2010 Culture, Stress and Recovery from Schizophrenia: Lessons from the

            Field for Global Mental Health, Cult. Med. And Psychiatry. 34: 500-528.

Santiago-Irizarry, V. 1996 Culture as Cure, Cultural Anth. 11(1): 3-24.

Shapiro, AK and Shapiro, E. 1997 the Placebo: Is It Much Ado about Nothing, in A.

            Harrington (ed.) The Placebo Effect: An Interdisciplinary Exploration.

            Cambridge, MA: Harvard Univ. Press: 12-36.

5/09/14 Final Papers due

Readings for doing the Cultural Assessment. Your final assignment is to do a cultural formulation.  We will talk much more about this in class, but here are readings about the Cultural Formulation as well as examples to help guide your efforts.

 

                        Movie: Culture of Emotions (On Reserve)

Excellent Student Example

Larry Merkel, MD, PhD Cultural Formulation.  This is a guide that I have written up.

Group for the Advancement of Psychiatry, 2002. Chapter 3: Cultural Formulation:

Description and Clinical Use, Cultural Assessment in Clinical Psychiatry.

Washington D.C.: American Psychiatric Publishing. Inc. 53-63.

Kleinman, A. and Benson, P. 2006 Anthropology in the Clinic: the Problem of Cultural

            Competency and How to Fix It, PLoS Medicine. 3(10): 1673-

Mezzich, JE, Carracci, G, Fabrega, H., Kirmayer, LJ. 2009 Cultural Formulation

            Guidelines, Transcultural Psychiatry. 46(3): 383-405.

Examples of Cultural Formulations:

Cheung, F. and Lin, K-M. 1997 Neurasthenia, Depression and Somatoform Disorder in a

            Chinese-Vietnamese Woman Migrant, Culture, Medicine, and Psychiatry. 21:

            247-258.

Group for the Advancement of Psychiatry, 2002 The “Good Catholic Girl”. In , Cultural

            Assessment in Clinical Psychiatry. Washington D.C.: American Psychiatric

            Publishing. Inc.: 136-

Group for the Advancement of Psychiatry, 2002 A South American Minister. In

            Cultural Assessment in Clinical Psychiatry. Washington D.C.: American

            Psychiatric Publishing. Inc.: 149-

Group for the Advancement of Psychiatry, 2002 An Asian American Student’s

            Reticence, In Cultural Assessment in Clinical Psychiatry. Washington D.C.:

            American Psychiatric Publishing. Inc.: 101-

Lizardi, D, Oquendo, MA, Graver, R. 2009 Clinical Pitfalls in the Diagnosis of Ataque de

            Nervios: A Case Study, Transcultural Psychiatry. 46(3): 463-486.

Mezzich, JE, Carracci, G, Fabrega, H., Kirmayer, LJ. 2009 Case 3. A Bi-Racial Baptist

            Veteran in New York – Online Supplement, Transcultural Psychiatry. 46(3): 383-

            405.

Mezzich, JE, Carracci, G, Fabrega, H., Kirmayer, LJ. 2009 Case 6. A Dominican

            Immigrant Woman – Online Supplement, Transcultural Psychiatry. 46(3): 383-

            405.

Oquendo, MA and Graver, R. 1997 Treatment of an Indian Woman with Major

            Depression by a Latina Therapist: Cultural Formulation, Culture, Medicine, and

            Psychiatry. 21: 115-126.

Yeung, AS and Chang, DF. 2002 Adjustment Disorder: Intergenerational Conflict in a

            Chinese Immigrant Family: Clinical Case Study, Culture, Medicine, and

            Psychiatry. 25: 509-525.