2. Culture and Race
Culture bound syndrome
Preferentially displayed in particular socio-cultural contexts
Given culturally sanctioned contexts
Have culturally specific remedies
Examples
Ataque de nervios-uncontrollable shouting trembling, crying and
dissociative experiences (Latin Carribean )
Falling out-sudden collapse accompanied by dizziness and
complaints of being unable to see, closely resembles hysterical
conversion (Southern United States)
Mal de ojo-fitful sleep, crying, diarrhea, vomiting and fever
3. Culture bound syndrome examples
Spell-commnication with dead persons or spirits (Southern US)
Anorexia-nervosa- refusal to eat, fear of being fat, altered body
image, lanugo, amennorhea (US, South America, and Europe)
Susto- unhappiness and sickness following a frightening event
which caused the soul to leave the body (Latinos)
Koro- fear that the penis in men and nipples and vluva in women
will disappear into the body (South and East Asia)
Latah- echopraxia, echolalia, and command obedience folllowing
a frightening event (Malaysia)
Postpartum depression-crying, irritability, poor concentration
from one year to two years following giving birth (US)
4. Therapies for culture bound syndromes
Culture specific and ethno-related
Bio-medical models usually ineffective
Need knowledge of the patient’s explanatory model of illness
(What does patient think caused the illness?)
Need knowledge of the patient’s explanatory model of cure
(How does patient think the illness can be cured?)
Cognitive behavioral therapy can help.
5. Gender Identity Disorders
Children
Symptoms of wanting to be the other sex are evident before
age 3
Sex ratio of referred children under the age of 12 is 4 to 5 boys
for 1 girl
Girls insist they have a penis, refuse to urinate in a sitting
position, have an avid interest in playing with male
companions and in rough and tumble sports
Boys enjoy wearing female clothes, are disgusted by their
genitalia and believe they will grow up to be women.
6. Adolescents and adults
Desire to be of the other sex
Do not identify as homosexual, gay, or lesbian
Desire to have treatment to change to sex
Uncomfortable wearing clothes of their assigned sex
Dysphoria with sexual condition
7. Intersex Conditions
Congenital viralization adrenal hyperplasia
Overproduction of androgens in a female-trypically raised as
boys-many have gender identity disorder
Androgen insensitivity syndrome
XY karyotype-tissue unable to use testosterone- raised as girls
but have undeveloped testes-usually sense themselves as
female
Turner’s syndrome- missing a Y sex chromosome karyotype X
female genitalia but require exogenous estrogen to develop
secondary sex characteristics
8. Kleinfeler’s syndrome- extra X chromosome XXY causes
gynecomastia and small testes- resultant dysphoric mood
Reductase deficiency
Male appears female at birth and does not viralize until
puberty-gender confusion results
Hermaphrodism and pseudohermaphrodism-
Presence of both sex genitalia or ambiguous genitalia
