3.) Discuss cultural and ethical considerations in diagnosis.
I. Intro – potential negative effects of disorder labeling (then dive right in to ethical considerations)
II. Stigmatization – defining a person by their disorder – DSM-IV suggests separate the person from the illness to avoid the isolation this could cause
III. Self-fulfilling prophecy – easily effect the mentality of a person who is diagnosed with a mental disorder
- Explain effect of schemas in views that cause this affect-
- Abelson (1974) – Ppl shown a video of a man telling another man about his job experience. One group told he was an applicant, the other told he was a patient. The patient mindset group described him with negative words, the applicant group with positive.
IV. Institutionalization
- Once patients are institutionalized, all behavior is contributed to the disorder in some way
- Can have an effect of powerlessness and depersonalization – no control over life, and potential abuse
V. Other biases that can affect a diagnosis:
- Racial/ethnic bias – diagnosis made based on race (find study to support it)
- Confirmation bias – ex. Rosenhan’s study where ppl were accused, but falsely
VI. Cultural Considerations in Diagnosis:
- Some disorders may be universal, but it’s possible for “culture-bound syndromes” to exist
- Reporting bias – just because some go to a hospital doesn’t mean all those afflicted do – potentially misleading data
- Largely part of the symptomology of disorders – Marsella (2003) says depression manifests in affection (emotional) forms more in individualist cultures – in collectivist cultures, somatic (physiological/physical) symptoms are more commonly reported.
- Somatization – Kleiman (1984), physical symptoms caused by psychological disorders
- Another problem is cultural blindness – a mental illness appears in a society that isn’t familiar with the symptoms – therefore, can’t diagnose or treat it
VII. Problem with Western Diagnostic System (DSM-IV, still part of the Cultural section) according to Marsella & Yamada (2007)
- Western system is dominant rather than accurate
- Doesn’t normally consider cultural context
- Also doesn’t look at situational factors, only psychological state
Marsella & Yamada say 7 situational factors contribute to mental illness cross-culturally:
1. Social conditions (war, racism, national disasters, poverty)
2. Focuses more on individual than their experiences – too much emphasis on guilt
3. Messages from the media
4. How the “self” is represented – self-efficacy
5. Social class
6. Powerlessness, inequality, cultural disintegration
7. Creation of stigmas – classifying with mental illness label while ignoring culture
II. Stigmatization – defining a person by their disorder – DSM-IV suggests separate the person from the illness to avoid the isolation this could cause
III. Self-fulfilling prophecy – easily effect the mentality of a person who is diagnosed with a mental disorder
- Explain effect of schemas in views that cause this affect-
- Abelson (1974) – Ppl shown a video of a man telling another man about his job experience. One group told he was an applicant, the other told he was a patient. The patient mindset group described him with negative words, the applicant group with positive.
IV. Institutionalization
- Once patients are institutionalized, all behavior is contributed to the disorder in some way
- Can have an effect of powerlessness and depersonalization – no control over life, and potential abuse
V. Other biases that can affect a diagnosis:
- Racial/ethnic bias – diagnosis made based on race (find study to support it)
- Confirmation bias – ex. Rosenhan’s study where ppl were accused, but falsely
VI. Cultural Considerations in Diagnosis:
- Some disorders may be universal, but it’s possible for “culture-bound syndromes” to exist
- Reporting bias – just because some go to a hospital doesn’t mean all those afflicted do – potentially misleading data
- Largely part of the symptomology of disorders – Marsella (2003) says depression manifests in affection (emotional) forms more in individualist cultures – in collectivist cultures, somatic (physiological/physical) symptoms are more commonly reported.
- Somatization – Kleiman (1984), physical symptoms caused by psychological disorders
- Another problem is cultural blindness – a mental illness appears in a society that isn’t familiar with the symptoms – therefore, can’t diagnose or treat it
VII. Problem with Western Diagnostic System (DSM-IV, still part of the Cultural section) according to Marsella & Yamada (2007)
- Western system is dominant rather than accurate
- Doesn’t normally consider cultural context
- Also doesn’t look at situational factors, only psychological state
Marsella & Yamada say 7 situational factors contribute to mental illness cross-culturally:
1. Social conditions (war, racism, national disasters, poverty)
2. Focuses more on individual than their experiences – too much emphasis on guilt
3. Messages from the media
4. How the “self” is represented – self-efficacy
5. Social class
6. Powerlessness, inequality, cultural disintegration
7. Creation of stigmas – classifying with mental illness label while ignoring culture