Social competence and psychiatric symptomatology in Japan: a cross-cultural extension of earlier American findings

Comparisons of Psychopathology Across Cultures

Comparative cross-cultural studies of psychopathology were reviewed in relation to the parameters of incidence, mode of manifestation, patterning, response to treatment, and outcome. A general model was proposed of regarding such differences as the joint function of subject, observer, setting, community, and instrument factors. The findings surveyed, even in their present nondefinitive state, favor the notion of cultural plasticity of psychopathology and, moreover, converge in suggesting that psychopathology represents a caricature and an exaggeration of culturally shared adaptive patterns of behavior. For a more conclusive examination of this possibility, concurrent research on normal and abnormal subjects drawn from several cultures was proposed and a number of specific modes of implementing this objective were presented.

Clinical relevance of contemporary cultural psychiatry

In recent years, the field of cultural psychiatry has gained recognition and accumulated evidence of its clinical relevance. This article examines the intersections of culture and psychopathology and describes five independent but interrelated clinical dimensions that identify and define culture as: a) an interpretive/explanatory tool, b) a pathogenic/pathoplastic agent, c) a diagnostic/nosological factor, d) a therapeutic/protective element, and e) a service/management instrument. Along these lines, conceptual boundaries, clinical findings, specific applications, and research implications for each of the five dimensions are systematically reviewed. Cultural psychiatry adds significantly to the comprehensiveness of psychiatric evaluation and management and addresses prominent issues regarding understanding, classification, diagnosis, and competent treatment of most psychiatric disorders in every society and region of the world. Based on the strength of these clinical dimensions, and on the related educational and research efforts, cultural psychiatry can also contribute decisively to the design of comprehensive mental health policies.