The document discusses the impact of culture and context on perceptions of neurological illness. It presents both positive and negative cultural perceptions, and how these influence sources of support and the openness of medical professionals. Factors like concealability, progression, disruptiveness, perceived origin, and fear associated with a neurological condition can all influence the level of stigma it carries within a cultural group. Understanding these cultural influences is important for assessing and treating neurological disorders in a sensitive manner.

1. NEUROLOGY
THE FAR REACHING IMPACT

2. Psychological models of illness

ABSOLUTIST 
CULURAL RELATIVISM

Culture and context play no role 
Response to illness is culture driven

Illness can be measured with 
Illnesses are measured with culturally
standardized tests regardless of where bound measures
they occur

Treatments are bound by cultural values

Treatments around the world can be and beliefs
uniform

UNIVERSALISM

Basic psychological processes are common to all members of a species, while culture
influences the development and display of these psychological characteristics

Illness is measured by tests altered for culturally meaningful measures

Treatments given based on underlying process

3. NEGATIVE CULTURAL
PERCETIONS
of illness

Some Religious groups

Indian Cultures

Judgement of God

Disability is a punishment for past-life
sins

punishment

Latino cultures 
Chinese Cultures

Disability is a curse stemming from the 
Disability removes an individuals
“evil eye” legitimacy in the community

4. POSITIVE CULTURAL
PERCEPTIONS
of illness

NAVAJO

Reveres the ill person as a teacher

Brings a sixth sense to the community

Has a unique gift
Concerned that efforts to cure the illness will interfere with the message of the person

5. Sources of support

COLLECTIVIST 
INDIVIDUALISTIC
CULTURE CULTURE

Medical professionals

Family members

Social workers

Community groups

Paid carers

Social support groups

6. Sources of support

COLLECTIVIST 
INDIVIDUALISTIC
CULTURE CULTURE

Medical professionals

Family members

Social workers

Community groups

Paid carers

Social support groups

7. THE OPEN MEDICAL MIND

Can negotiate regarding cultural practices

Open to discussions

Willing to inform patients/family/community members

Allows for culturally bound options

8. Erving Goffman
defined stigma as ‘‘the situation
of the individual who is disqualified from full social
acceptance”

9. CONCEALABILITY
Can the neurological illness be hidden, or is it obvious?
Is the patient bound to a wheelchair?
Can they control their own body functions and movements (spasticity)?
Is there visible paralysis (hemiparesis)?
Is their speech slurred and/or overly loud (Aphasia)?
Is there evidence of incontinence?
Does the patient follow social norms?

10. COURSE
HOW WILL THE ILLNESS PROGRESS OVER TIME?
Will dementia worsen – cognitive abilities?
Will aphasia progress – comprehend and participate in communication?
Will the Pseudobulbar affect worsen – inappropriate laughing or crying?
Will depression worsen?
Will the ability to follow social norms diminish?

11. DISRUPTIVENESS
INTERFERENCE WITH USUAL PATTERNS OF SOCIAL INTERACTIONS
Cognitive abilities
Communication abilities
Vascular Dementia
Pseudobulbar affect, sometimes referred to as emotional lability, pathological crying
and laughing or emotional incontinence.

12. ORIGIN
PERCEIVED CAUSE AND LEVEL OF RESPONSIBILITY A PERSON HAS FOR
CONTRACTING THE ILLNESS
Poor lifestyle choices – excessive drinking, drugs, sexual behaviors, overweight etc
Perpetual self induced stress
Lack of self-care
Ignored warning signs

13. PERIL
FEAR AND DANGER ASSOCIATED WITH A PERSON'S ILLNESS
Can that happen to me?
How do I behave now they are sick?
Loss of the person I knew
Fear of embarrassing myself

14. References
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33(3), 223-242.
McCabe, M. P., Roberts, C., & Firth, L. (2008). Work and recreational changes among people with neurological illness and their caregivers.
Disability and Rehabilitation, 30(8), 600-610. doi: 10.1080/09638280701400276.
O’Connor, E. J., & McCabe, M. P. (2011). Predictors of quality of life in carers for people with a progressive neurological illness: A
longitudinal study. Quality Life Research, 20, 703-711. doi: 0.1007/s11136-010-9804-4.
Rao, D., Choi, S. W., Victorson, D., Bode, R., Peterman, A., Heinemann, A., & Cella, D. (2009). Measuring stigma across neurological
conditions: the development of the stigma scale for chronic illness (ssci). Quality of Life Research, 18, 585-595. doi: 10.1007/s11136-
009-9475-1.
Ravindran, N., & Myers, B. (2011). Cultural influences on perceptions of health, illness, and disability: A review and focus on autism. Journal
of Child and Family Studies, 21(2), 311-319. doi: 10.1007/s10826-011-9477.