Psychiatric diagnosis - is it universal or relative to culture?

被引:162
作者
Canino, Glorisa [1 ]
Alegria, Margarita [2 ]
机构
[1] Univ Puerto Rico, Sch Med, Behav Sci Res Inst, San Juan, PR 00936 USA
[2] Harvard Univ, Sch Med, Cambridge, MA 02138 USA
关键词
child psychiatric diagnosis; cultural differences; universalist approach; relativistic approach;
D O I
10.1111/j.1469-7610.2007.01854.x
中图分类号
B844 [发展心理学(人类心理学)];
学科分类号
040202 ;
摘要
Background: There is little consensus on the extent to which psychiatric disorders or syndromes are universal or the extent to which they differ on their core definitions and constellation of symptoms as a result of cultural or contextual factors. This controversy continues due to the lack of biological markers, imprecise measurement and the lack of a gold standard for validating most psychiatric conditions. Method: Empirical studies were used to present evidence in favor of or against a universalist or relativistic view of child psychiatric disorders using a model developed by Robins and Guze to determine the validity of psychiatric disorders. Results: The prevalence of some of the most common specific disorders and syndromes as well as its risk and protective factors vary across cultures, yet comorbid patterns and response to treatments vary little across cultures. Cross-cultural longitudinal data on outcomes is equivocal. Conclusions: The cross-cultural validity of child disorders may vary drastically depending on the disorder, but empirical evidence that attests for the cross-cultural validity of diagnostic criteria for each child disorder is lacking. There is a need for studies that investigate the extent to which gene-environment interactions are related to specific disorders across cultures. Clinicians are urged to consider culture and context in determining the way in which children's psychopathology may be manifested independent of their views. Recommendations for the upcoming classificatory system are provided so that practical or theoretical considerations are addressed about how culture and ethnic issues affect the assessment or treatment of specific disorders in children.
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页码:237 / 250
页数:14
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