Culture affects diagnosis. This is caused by the fact that the standards for abnormality differ from culture to culture and from society to society. This can cause problems when considering the validity and reliability of diagnosis.
An example which can be used to demonstrate one cultural consideration was the study conducted by Rack in 1982. After observing Asian (and more in particular Chinese) habits when considering psychological issues he affirmed that usually Asian people will not consult their doctor for an emotional or behavioural problem, but only for a physical one. This means that they will only be helped in case the problems becomes particularly severe. This has two effects. The first one is that it seems as if Chinese men and women have a particularly low rate of depression, but this is not true: they rarely ask for help and when they do doctors will rarely give them a diagnosis of depression since it is not really accepted in their culture. The second effect is instead the fact that they will be a lot worse when they are going to ask for help and this will cause a longer therapy, possibly heavier drugs and more consequences.
Another example related to cultural considerations is the observation conducted by Kleinman in 1984. After looking at Chinese and western depressed patients he observed how these two differed in symptoms. The results were really important to understand how a diagnosis can be unrealiable when looked at from at outsider. Apparently while people in western cultures demonstrate their depression with feelings of anxiety and sadness, people in China will demonstrate their depression somatizing their emotions. It usually happens that when Chinese men and women feel depressed the have more physical problems than emotional ones. An example can be the pain they often feel in their back.
Ethical considerations must also be brought up when considering diagnosis in the area of abnormal psychology. Often one does not think of how the diagnosis could affect the patient, but usually problems arise in these cases.
Szasz, in one of his reports, stated that people often use labels, such as mentally ill, to isolate others. This is called stigmatization. Stigmatization causes people who were given a psychological diagnosis to isolate themselves or to be isolated by others. This is due by the fact that when a diagnosis is made, often people feel as if they are someone else. Other people too are often regarding these as people who can be addressed to that specific group only. This causes in men and women less desire to be helped for the fear of being left alone.
Also Rosenhan with study conducted in 1973 demonstrated the presence of an ethical issue which should always be considered. He asked eight healthy people to gain admission to more than ten different psychiatric hospitals. When there they said they heard voices. They said the voices were unclear, of the same sex and saying one single word. When they got diagnosed schizophrenia they were asked to remain in observation in the hospital. After entering they started saying they felt fine. One of them was kept under observation for other fifty-two days. This is caused by the fact that patients in institutions are regarded as having something for the simple reason they are in there. This was also shown by the fact that the behaviour of the actors was always considered as representing the schizophrenic behaviour, even when it was something as simple as walking through the corridors for boredom.
It is possible to try lowering the levels of the issues caused by culture and ethics. Several “guides” to psychological diseases were created so that when someone is diagnosed based on that “guide”, it will maintain its diagnosis throughout all the world. Instead for ethical purposes now diagnosis are given in a less drastic way. Instead of being schizophrenic, for example, a person is considered to have “schizophrenic behaviour”. Even if decisions to get the situation better are made very often by psychologists interested in it, many other issues are still to be considered while diagnosing a mental disease.
by
landofconfusion (student)
