Culture & Mental Health Disorders (DP IB Psychology): Revision Note

Here is an example of a Paper 3 source and 15-mark ERQ using culture (HL extension) in the Health & Wellbeing context:

Source 5

One of the problems with cross-cultural research is that it may result in universal, ethnocentric or etic conclusions being made, i.e., the researcher(s) may (consciously or unconsciously) view their findings through the prism of their own cultural perspective.

Cultural relativism (CR) is the idea that not all cultures are the same and there is no one ‘superior’ culture: diversity should be respected and accounted for in research.

CR emphasises the idea that behaviour should be understood in the context of the culture itself rather than making judgements based purely on the behaviour in question.

Using a CR approach to research involves a lack of judgement of cultures which are different from the cultural norms of whomever is conducting the research.

CR means that a researcher should try to understand cultural practices from within that culture so that instead of making value-judgements about the culture, the researcher asks interested questions e.g. ‘Why is it that latah exists in Malaysia and Indonesia?’ (latah presents as hypersensitivity to sudden fright, often with echopraxia, echolalia, command obedience, and dissociative or trance-like behaviour).

Western individualistic clinicians who are not familiar with collectivist cultures may misdiagnose mental disorders due to a lack of cultural knowledge.  Different cultures have different values so trying to apply a universal model of treatment (specifically, the biomedical model with its emphasis on the physiological aetiology of disorders) across cultures does not account for CR.

Some cultures are wary of disorders such as MDD so their criteria for treating depressive symptoms will be based on their own cultural understanding of the condition rather than on a course of antidepressants. In Ethiopia there is a condition known as 'zar', which a Western clinician may treat as MDD (as it involves weeping, apathy, withdrawal, and loss of appetite). This ignores the cultural context, which is that symptoms are attributed to spirit possession with the possibility of the person developing a long-term relationship with the possessing spirit.

Q4: To what extent can we conclude that the diagnosis of mental disorders is biased in favour of the biomedical model? In your answer, use your own knowledge and at least three of sources 2–5.

[15 marks]

Model answer:

(Here are two paragraphs which could appear as part of a longer response to this question.)

The source explores the disconnect between traditional culture-bound syndromes and the Western biomedical model of disorders. The source explains that there may be cultural bias built into the biomedical model, as it takes a universal view of health, ascribing diagnoses based on statistical manuals (e.g., the ICD-11) rather than using local knowledge as a guide. Cultural relativism is missing from this approach, which can have harmful consequences.

For example, if an Ethiopian patient presents with 'zar', this is likely to go unnoticed by a Western doctor, which means that the subtleties and nuances of the condition are lost in translation. Diagnosing 'zar' as MDD could be catastrophic for the patient as they struggle to cope with a negative label when, instead, a culturally relativist approach could have enabled them to accept their condition more positively and use culturally relevant ways of managing it.

Guidance

• Weigh up the relative merits of the claim

  • What is there in this (and other) source(s) that could be used to back up this argument?

  • Do you know of any research or examples which could be used to validate the idea that the biomedical model is ethnocentric and culturally biased?

• Consider the difficulties facing clinicians who are not familiar with different cultures in applying cultural relativism to diagnosis

  • What are the implications for educating and training clinicians in different cultural perspectives?

• Make sure that your argument is informed by the sources and that it draws from the relevant topics featured in this context

• Include concepts (e.g., causality, bias) to inform your critical thinking and discussion of the source(s) as well as any real-world or anecdotal examples you are aware of