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*Please read chapter 12

Consider this excerpt from Drafa, D, & Nagel, S.K. (2014). Group Differences in Mental Disorders. World Cultural Psychiatry Research Review, 9 (3): 144-150.

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“Mental health research is currently undergoing a challenge of diversity. On the one hand, diagnosis is not always clear-cut due to the inhomogeneity of disorder symptoms and presentations across individuals (American Psychiatric Association, 2013; Kraemer et al, 2012). On the other, external factors, such as differing environmental and social environments appear to play roles in shaping symptom distributions and idioms of distress across cultures and patient groups (Kohrt et al, 2014; Escobar & Gureje, 2007; e.g., Grover & Ghosh, 2014; Keys et al, 2012). Globalization has increased immigration and diversification across the ‘Western’ world, and mental health clinicians are treating patients from diverse cultural backgrounds more frequently now than in the past. Many patients bring different customs and cultural expectations with them. These differences can lead to clinical misunderstandings, such as over-diagnosis or misdiagnosis (Adeponle et al, 2012; e.g., Fountain et al, 2011; Mandell et al, 2009; Raghavan, 2009), which have been well-documented and are increasingly addressed through cultural competence trainings and targeted research studies. However, neuropsychiatric research is one area of psychiatry that remains grossly negligent of cultural differences. Currently, very few studies have used neuroscientific methods, such as eye tracking or fMRI, to investigate clinically relevant differences in patient populations. Surprisingly, this neglect continues in the face of findings from cultural neuroscience (CN) that robustly demonstrate the influence culture can have on clinically-relevant neurobehavioral processes: multiple culture-based differences have been reported in brain regions that exhibit distinct activity in many disorders, such as the prefrontal cortex, cingulate cortex, parietal lobe, and amygdala, which show different processes in disorders like schizophrenia, post-traumatic stress disorder, autism, major depression, and general anxiety disorder (Crafa & Nagel, in press). The absence of cultural neuropsychiatric literature creates a two-fold problem: First, only a small portion of the global population is represented in this research. A majority of neuroscience research comes from Caucasian populations in Western Europe and North America (Henrich et al, 2010a; 2010b).”

Compose a well written essay (1-2 paragraphs, roughly 400-600 words) in response to these questions…

1. Briefly summarize what you have come to learn about the importance of sociocultural research in mental illness. Integrate the Crafa & Nagal excerpt as well as the textbook.

2. Often the difference between cultures (i.e. comparing those living in America to those in India) are nothing when compared to the differences within a culture (i.e. comparing Americans with themselves). Discuss how this statement can be seen in the following two research findings your textbook mention:

a. Although schizophrenia appears in all socioeconomic groups, it is found more frequently at the lower economic levels. Downward drift theory suggests that the stress of poverty itself is a cause of schizophrenia. However, it could be that schizophrenia causes its sufferers to fall from a higher to lower socioeconomic level or to remain poor because they are unable to function effectively.

b. According to a 10-country study by the World Health Organization, the 25 million patients with schizophrenia who live in developing countries (eg. Columbia, India, Nigeria) have better recovery rates than those in developed countries (eg. the Czech Republic, Denmark, Ireland, Japan, Russia, United Kingdom, Untied States)

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