Toward a Culture-Bound Syndrome-Based Insanity Defense?

Abstract

The American Psychiatric Association's recent inclusion of a Glossary of Culture-Bound Syndromes within DSM-IV draws upon decades of medical anthropological and cultural psychiatric research to afford culture-bound syndromes (CBSs) a newfound legitimacy within professional Western psychiatric nosology. While DSM-IV's recognition of the CBS concept as a category of psychosocial distress has important clinical implications for mental health care practitioners throughout the world, it also has significant legal implications. Given that several CBSs involve a degree of psychological impairment that may satisfy the standard for legal insanity under certain circumstances, this essay focuses on the potential emergence of an insanity defense based on the claim that an immigrant or minority defendant was suffering from a CBS at the time of his or her criminal act. Aimed at initiating interdisciplinary debate over the reification of the CBS concept, the essay discusses the theoretical ambiguity and status of CBSs within professional Western psychiatry, describes what a CBS-based insanity defense might look like, and considers the relevant challenges facing medical anthropologists and cultural psychiatrists, on the one hand, and legal practitioners, on the other. The essay identifies a pressing need for interdisciplinary debate concerning the validity, scope, and viability of CBS-based insanity defenses.

An international perspective on criminal responsibility and mental illness.

“…Future research should also explore the application of culture-bound syndromes to the insanity defense in jurisdictions throughout the world (cf. Parzen, 2003) because there is a paucity of research in this area.…”

“…Fortunately, in recent years many countries have shifted their diagnostic criteria to coincide with the Diagnostic and Statistical Manual of Mental Disorders (fifth edition; DSM–5 ; American Psychiatric Association, 2013) and/or International Classification of Diseases, Tenth Edition (ICD-10; World Health Organization, 2013); therefore, many evaluators may be speaking the same diagnostic language. Even so, particular symptom constellations may characterize a culture-bound syndrome that is recognized in some jurisdictions but not others (Parzen, 2003).…”

“…Palermo notes that personality disorders are an “enduring pattern of inner experience and behavior that markedly deviates from the expectations of an individual’s culture”; therefore, it follows that there are differences in how such disorders are approached between cultures (Palermo, 2007, p. 127). Similarly, major mental illnesses (i.e., Axis I using DSM–IV–TR nosology) are typically diagnosed with consideration of what is “normal” in an examinee’s culture(s) as well as what is considered to be adaptive within that cultural framework (American Psychiatric Association, 2013; Parzen, 2003).…”

Going Berserk: Battle Trance and Ecstatic Holy Warriors in the European War Magic Tradition

“…Culturallybound syndromes were dropped from the DSM-5 as a category. IED, poorly defined (e.g., Ahmed, Green, McCloskey, & Berman;, 2010;Parzen, 2003), is considered a disruptive impulse control and conduct disorder characterized by unpremeditated explosive outbursts of rage disproportionate to the situation, which may happen more or less chronically and frequently, or with relatively infrequent, high-intensity outbursts resulting in injury or destruction of property (APA, 1980(APA, , 1994(APA, , 2013). An illustration given of the way the APA understands amok, similar to the way it regards "going berserk," was that of a Filipino man who, upon learning that his wife was having an affair, killed her parents, injured her and their son, and then set fire to the house of his wife's lover's brother, which killed two children living there (Parzen, 2003, p. 142).…”