Cultural concepts of distress and psychiatric disorders: Understanding symptom experience and expression in context

Abstract

The term ''cultural concepts of distress'' (CCD) was introduced in DSM-5 to better characterize the broad set of constructs identified in clinical and ethnographic research on cultural variations in distress. 1 Much work in medical anthropology on cultural variations in distress has been framed in terms of ''idioms of distress'' (Nichter, 1981, 2010) and this is the term used by most of the articles in this special issue to cover a range of symptoms, syndromes, and modes of expression. In the DSM-5, however, ''idiom of distress'' denotes only one type of CCD and is distinguished from explanatory models, syndromes, and folk illness categories. The term ''idiom'' is meant to emphasize the communicative function of a CCD as a local linguistic or nonverbal mode of expression (Lewis-Ferna´ndez, Kirmayer, Guarnaccia, & Ruiz, 2017). The term ''idiom'' also does not presuppose pathology; the same idiom can be used to denote everyday concerns or subclinical levels of affliction as well as more severe forms of suffering that lead to help seeking. Of course, cultural idioms are used to talk about other facts of experience that may or Commentary

Characteristics of Adolescents Affected by Mass Psychogenic Illness Outbreaks in Schools in Nepal: A Case-Control Study

“…In the context of extreme oppression, MPI symptoms may function as a psychological defense or social expression of distress that is comprehensible in terms of local cultural models of affliction (101,102). MPI symptoms may operate as local cultural idioms of distress, modes of communication that serve the afflicted individual's ongoing efforts to adapt to and survive in challenging social circumstances (103)(104)(105)(106). Ethnographic studies have suggested, for example, that spirit possession may provide women or marginalized subgroups with the means to express distress in contexts where more direct expression is impossible or may have adverse effects (107,108).…”

Help-Seeking Attitudes and Distress Disclosure Among Syrian Refugees in Germany

“…In this context, one has to consider that beliefs surrounding causes of illness, evaluation of treatment, and stigmatization are largely socially and culturally constructed (Kleinman, 1980; Lewis-Fernández & Kirmayer, 2019; Link & Phelan, 2001). In Syria, suffering is commonly conceptualized as a part of life that one must handle, often resulting in very indirect expressions of mental health problems (see Hassan et al, 2015, for a provision of specific idioms that Syrians use to express distress).…”

Culture-bound syndromes, idioms of distress, and cultural concepts of distress: New directions for an old concept in psychological anthropology

“…Scholars like Devon Hinton (Hinton, Pich, Marques, Nickerson & Pollack, 2010;Hinton, Reis & de Jong, 2015) have proposed extensive research agendas to incorporate and test the use of idioms of distress in interventions. And in the most recent version of the DSM (5th edition, 2013), the term ''cultural concepts of distress'' has replaced the outdated terminology of culture-bound syndromes (Lewis-Ferna´ndez & Kirmayer, 2019). This change was intended to signal a broader, more inclusive understanding of culturally specific distress as something that changes over time and does not represent place-specific ''exotica.''…”