Could a behavior be considered abnormal in one culture and normal in another?

Culture and Mental Health

2016, Encyclopedia of Mental Health: Second Edition

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The North American continent is comprised of a diverse array of individuals who range culturally. A substantial number practice diverse approaches to health and have mental health issues that are dissimilar from mainstream culture. In this article, we define culture and mental health, review some major health disparities, and summarize the basic factors surrounding assessment and treatment of mental health across cultural groups. We base our discussion in the context of health disparities, the existence of which presents a major problem for healthcare in America, and with an eye towards aiding the development of cultural competence for clinicians and healthcare providers nationwide.

A consideration of hoarding disorder symptoms in China

2015, Comprehensive Psychiatry

Citation Excerpt :

One possibility is that hoarding in China is associated with different vulnerabilities than hoarding in US/European cultures. Alternatively, hoarding beliefs may represent a post-hoc explanation for why an item was acquired or saved, and is plausible that culture could enact a strong influence on shaping these rationalizations [12,13]. Another hypothesized explanation for the stronger endorsement of hoarding symptoms and beliefs in the Chinese sample is a potentially culture-specific response tendency to rate items at the extremes.

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Hoarding disorder is rarely examined in populations of non-European and/or non-Euro-American descent, especially in East Asian nations like China. Across two studies, the current investigation sets out to examine the psychometric properties of a Chinese version of a widely used measure of hoarding symptoms—the Savings Inventory Revised (SIR)—and to explore the nature of hoarding beliefs compared to a separate US sample.

For the first study, 1828 college students in China completed a Mandarin translation of the SIR and measures of anxiety, depression, and obsessive-compulsive disorder. For the second study, 303 students from China and 87 students from the US completed the SIR and a novel hoarding beliefs questionnaire.

In the first study, the Chinese-version of the SIR demonstrated convergent and discriminant validity, as well as internal reliability and preliminary construct validity. However, evidence of temporal stability was modest and requires further investigation. In the second study, the Chinese sample endorsed greater hoarding symptoms and hoarding beliefs compared to the US sample, although only themes of usefulness and wastefulness were associated with hoarding in the Chinese samples, whereas a wider range of beliefs was linked with hoarding in the US sample. In addition, the factor structure of the SIR from the first study did not replicate in second study, suggesting that construct validity of the Chinese SIR may require further corroboration.

The current study established preliminary evidence for the reliability and validity of the Chinese SIR, although future research is needed to confirm its temporal stability and factor structure. Hoarding beliefs in China may be centered on themes of usefulness and wastefulness compared to more heterogeneous themes in the West, suggesting differential manifestations of hoarding tendencies in cultures of non-European and/or non-Euro-American descent.

Recognizing and dealing with cultural influences in psychotherapy

2006, Clinical Strategies for Becoming a Master Psychotherapist

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This chapter focuses on the effects of cultural influences on psychotherapy. The increasing recognition of cultural influences in the psychotherapeutic context is a reflection of increased cultural diversity in society. Several researches examining the influence of culture on psychopathology have been shaped by two distinct conceptualizations. One conceptual model views culture as permeating all aspects of psychological distress. Culture and psychopathology are intertwined and are part of a holistic experience. Based on this model, there would be no advantage in comparing psychological distress across cultures because of the uniqueness of each culture. The second model discourages the role of culture in defining psychological experiences. In this model, the focus is on examining common psychological experiences that go across different cultures. These two conceptual models have led to the use of two distinct approaches in conducting cross-cultural research—the emic approach and the etic approach. The emic research model favors qualitative and descriptive research that tends to demonstrate the uniqueness of a culture and discourages western conceptualizations of psychological distress. An etic research model is based on concepts, methods, and measures that apply to all cultures. This model would essentially capture a construct of interest and attempt to measure it in a standardized manner across different cultures.

A cross-cultural, long-term outcome evaluation of the ISTAR Comprehensive Stuttering Program across Dutch and Canadian adults who stutter

2006, Journal of Fluency Disorders

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There is a need to evaluate the effectiveness of stuttering treatment programs delivered in domestic and international contexts and to determine if treatment delivered internationally is culturally sensitive. Evaluation of the effectiveness of the ISTAR Comprehensive Stuttering Program (CSP) within and across client groups from the Netherlands and Canada revealed generally positive results. At 2 years post-treatment both groups were maintaining statistically significant reductions in stuttering frequency and improvements in attitudes, confidence, and perceptions as measured by the Revised Communication Attitude Inventory (S24), Perceptions of Stuttering Inventory (PSI), and the approach scale of the Self-Efficacy Scaling by Adult Stutterers (SESAS). Data pooled across the groups on these measures gave evidence of a global treatment effect with standardized effect sizes ranging from typical to larger than typical in the behavioural sciences. Only two differences between the groups emerged: differences in speech rate and perception of self. Given that these groups represent two distinct cultures, differences were discussed in terms of whether they could be due to cultural, methodological, or other variables. Overall, results suggest that, the CSP appears to be similarly effective in both cultures and thus, sufficiently sensitive to the culture of Dutch adults who stutter.

Educational objectives: The reader will be able to (a) describe a methodology that can be used in a clinical setting to evaluate the long-term effectiveness of stuttering treatment with adults, (b) describe some of the challenges in developing a model of clinically meaningful outcome, (c) explain the rationale for the need for cross-cultural investigations of treatment outcome, and (d) summarize speech and self-report results of the cross-cultural evaluation of an integrated stuttering treatment program.

Assessment of psychopathology across and within cultures: Issues and findings

2003, Behaviour Research and Therapy

Citation Excerpt :

In Hofstede’s (2001) recent reformulation, its gist boils down to long-term orientation in relation to values, goals, and rewards. The above five dimensions were extended beyond their original industrial organizational context to the school setting (Hofstede, 1986), the psychotherapy enterprise (Draguns, 1995, 1997), and the experience of subjective well-being (Arrindell et al., 1997). Expectations appear to be justified that Hofstede’s continua are also relevant to psychopathology.

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Research based information on the impact of culture on psychopathology is reviewed, with particular reference to depression, somatization, schizophrenia, anxiety, and dissociation. A number of worldwide constants in the incidence and mode of expression of psychological disorders are identified, especially in relation to schizophrenia and depression. The scope of variation of psychopathological manifestations across cultures is impressive. Two tasks for future investigations involve the determination of the generic relationship between psychological disturbance and culture and the specification of links between cultural characteristics and psychopathology. To this end, hypotheses are advanced pertaining to the cultural dimensions investigated by Hofstede and their possible reflection in psychiatric symptomatology. It is concluded that the interrelationship of culture and psychopathology should be studied in context and that observer, institution, and community variables should be investigated together with the person’s experience of distress and disability.

Training Implications of Harmful Effects of Psychological Treatments

2010, American Psychologist

Research article

The Importance of Extreme Weight Percentile in Postoperative Morbidity in Children

Journal of the American College of Surgeons, Volume 218, Issue 5, 2014, pp. 988-996

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Anthropometric data are important indicators of child health. This study sought to determine whether anthropometric data of extreme weight were significant predictors of perioperative morbidity in pediatric surgery.

This was a cohort study of children 29 days up to 18 years of age undergoing surgical procedures at participating American College of Surgeons’ NSQIP Pediatric hospitals in 2011 and 2012. The primary outcomes were composite morbidity and surgical site infection. The primary predictor of interest was weight percentile, which was divided into the following categories: ≤5th percentile, 6th to 94th, or ≥95th percentile. A hierarchical multivariate logistic model, adjusting for procedure case mix, demographic, and clinical patient characteristic variables, was used to quantify the relationship between weight percentile category and outcomes.

Children in the ≤5th weight percentile had 1.19-fold higher odds of overall postoperative morbidity developing than children in the nonextreme range (95% CI, 1.10–1.30) when controlling for clinical variables. Yet these children did not have higher odds of surgical site infection developing. Children in the ≥95th weight percentile did not have a significant increase in overall postoperative morbidity. However, they were at 1.35-fold increased odds of surgical site infection compared with those in the nonextreme range when controlling for clinical variables (95% CI, 1.16–1.57).

Both extremely high and extremely low weight percentile scores can be associated with increased postoperative complications after controlling for clinical variables.

Research article

Association Of Bleeding Avoidance Strategies with age-related bleeding and In-hospital mortality in patients undergoing percutaneous coronary Interventions

Cardiovascular Revascularization Medicine, Volume 17, Issue 4, 2016, pp. 233-240

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The association of bleeding avoidance strategy (BAS) (consisting of a combination of radial access, bivalirudin [rather than heparin +/− glycoprotein GPIIb/IIIa antagonists], and/or vascular closure devices after femoral access) with bleeding and in-hospital outcomes has not been evaluated among elderly patients undergoing percutaneous coronary interventions (PCI).

We studied BAS use, bleeding and in-hospital mortality among 121,635 patients categorized by age (< 50, 50–59, 60–69, 70–79, and ≥ 80 years) undergoing PCI from the BMC2 registry (1/2010–12/2013).

The use of BAS decreased marginally with age and despite improved utilization over time, remained lower among the elderly. BAS was used in a much lower risk cohort among all age groups. Nonetheless, compared with no BAS, the use of this strategy was associated with lower bleeding (adjusted OR 0.984, 95% CI 0.980–0.985) and in-hospital mortality (adjusted OR 0.996, 95% CI 0.994–0.997) among all age-groups. Similar relative reduction in the risk of bleeding was observed among all age groups with BAS use with lowest risk (thus greatest absolute risk reduction given their highest risk for bleeding) for the oldest cohort.

BAS use decreased with age among patients undergoing PCI despite its association with lower in-hospital mortality. Although overall utilization improved over time, it still remained lower in the elderly cohort, a group likely to benefit most from it. These data identified an opportunity to design strategies to improve BAS use particularly among high-risk elderly patients undergoing PCI so as to decrease bleeding and reduce related adverse events and costs.

Research article

The choice of arterial access for percutaneous coronary intervention and its impact on outcome: An expert opinion perspective

American Heart Journal, Volume 170, Issue 1, 2015, pp. 13-22

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The prevention of major bleeding during percutaneous coronary intervention is one of the most widely discussed and often controversial topics within interventional cardiology. The choice of arterial access should be considered a mechanism for bleeding avoidance, and various strategies have been proposed to prevent or lower major bleeding and vascular complications with varying levels of strength. Herein, we review the current literature on arterial access as a bleeding avoidance strategy during percutaneous coronary intervention and its impact on outcome and provide a consensus opinion based on the strength of the evidence supporting various techniques.

Research article

Convenient synthesis of alkyl and phenylalkyl β-d-glucopyranosides using facile and novel biocatalysts of plant origin

Industrial Crops and Products, Volume 74, 2015, pp. 918-924

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Several kinds of fruit and vegetable seed meals were examined as the novel biocatalysts for the synthesis of alkyl and phenylalkyl glycosides, an important group of nonionic surfactants, from d-glucose and primary alcohols. The crude enzymes from prune and black plum seeds displayed comparable or slightly higher catalytic efficiency and better operational stability as compared to those from apple and peach seeds. These alkyl glycosides were synthesized with the yields of 14–78% using prune seed meals. In addition, synthetic yields of alkyl and phenylalkyl glycosides decreased dramatically with the elongation of the chain of the primary alcohols. In the synthesis of octyl β-d-glucopyranoside, the maximal yield of 14% was obtained with prune seed meals. However, in the synthesis of ethyl, propyl and butyl β-d-glucopyranoside with the same catalyst, the yields were 78%, 69% and 53%, respectively, which were much higher than that of octyl β-d-glucopyranoside. Enzymatic synthesis of butyl β-d-glucopyranoside was conducted on a 0.9 g scale, with an average isolated yield of 30% for the first two batches.

Research article

Probability Theory: Formal

International Encyclopedia of the Social & Behavioral Sciences, 2015, pp. 33-36

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Probability theory is a branch of mathematics that evolved from the investigation of social, behavioral, and physical phenomena that are influenced by randomness and uncertainty. This article begins its survey of probability theory with a discussion of the impact of A.N. Kolmogorov's framework for the mathematical understanding of probability and the role that his axioms had in transforming probability from a modeling art to a mathematical science. The survey then discusses the important notion of a random variable, and the tools for describing such variables, including means, variances, distribution functions, densities, and the fundamental property of independence. The article also discusses the law of large numbers – the mathematical result that underlies the popular ‘law of averages’ and the central limit theorem – the mathematical result that suggests why the ‘bell curve’ is present in many social and physical phenomena. The article concludes by reviewing sources of further information on probability theory.

Can a behavior be normal in one culture but abnormal in another?

What is a behavior or practice that is considered wrong in one culture but acceptable in another culture?

When can a behavior be considered abnormal?

What is culturally abnormal Behaviour?