Concept Check
Identify the three major themes this book takes in regard to psychopathology.
What does level of analysis mean? Identify seven of the levels of analysis presented for studying psychopathology. Which is the most important?
How is the biopsychosocial model related to the broader levels of analysis approach?
Culture: How are we a part of culture, and what is its influence?
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Social relationships: How do we relate to others?
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Individual: How do we relate to ourselves in terms of behavior and experience?
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The Relation of Evolution and Culture to Psychopathology
Considering psychopathology from evolutionary and cultural perspectives goes beyond the traditional psychological and physiological considerations (Ray, 2013). These perspectives make us realize that for at least the last 100,000 years, humans have been social beings who have lived within the context of a group in which there were interactions related to gathering and preparing food, having sexual relations, and being part of a community. Cultures developed from this.
cultural perspective: examines the social world in which a person lives and from which a person learns skills, values, beliefs, attitudes, and other information
The cultural perspective emphasizes the social world in which a person lives (López & Guarnaccia, 2000). In this sense, culture can be viewed as “information capable of affecting individuals’ behavior that they acquire from other members of their species through teaching, imitation, and other forms of social transmission” (Richerson & Boyd, 2005). From this perspective, culture can be seen as a system of inheritance. Humans learn a variety of things from others in their culture including skills, values, beliefs, and attitudes. Historically, parents and others taught children how to perform particular tasks such as farming, toolmaking, and hunting. In addition, human culture has formalized learning in the form of schools and apprenticeships. Cultures also differ in their level of economic development and the amount of resources they devote to mental health. In Cultural LENS: Global Mental Health: Available Treatment, the availability of mental health professionals across the world is described.
Figure 1.2 The Biopsychosocial Model
For a more complete understanding of psychopathology, it is important to understand the particular rules a culture has for expressing both internal experiences and external behaviors (Marsella & Yamada, 2010). What may be a common stress-free experience in one culture may lead to stress and anxiety in another. Even what individuals tell themselves about having a mental disorder can vary from culture to culture. Likewise, artistic and spiritual experiences considered normal in one society may be considered “crazy” in another.
Historically, a simplistic view of culture has emphasized how each culture is locally determined, without reference to universal psychological processes. When universal ways of behaving, feeling, or thinking are suggested, this view assumes that this information is acquired by social learning. Although this is an important aspect of culture, such an emphasis will quickly lead you into the outdated nature–nurture debate, which lacks the insights of modern evolutionary and neuroscience perspectives. For example, consider the question of why foods with milk are found in European diets and not in Asian diets. One answer could be cultural preferences. However, a more complete answer includes the fact that Northern Europeans have a gene that allows them to continue digesting milk products after the traditional time of weaning.
Genetics: How do genes influence the environment, and how does the environment influence genes?
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A person with such a gene would have had an advantage in Northern Europe, since dairy products are a high-quality food source, and over time—probably less than 10,000 years—that advantage would have allowed these genes to be passed on to almost all of the European population. Today, 98% of all individuals in Sweden have this gene. In the United States, with its large European migration, 88% of white Americans are lactose tolerant, meaning they can digest milk products. Native Americans, on the other hand, are lactose intolerant. Overall, this suggests a close connection between cultural and evolutionary perspectives.
The picture becomes even more complicated in terms of psychological processes. There is a particular form of a gene (5-HTT) related to the neurotransmitter serotonin that is associated with being prone to develop higher levels of anxiety and depression. When its occurrence is examined cross-culturally, studies have shown that 70 to 80% of Japanese individuals carry this gene, whereas only 40 to 45% of Europeans carry it (see Ambady & Bharucha, 2009). Likewise, brain imaging studies have shown that cultural values can influence which areas of the brain are active during self-evaluation (Chiao, 2011).
The larger question raised by these studies is whether this genetic variation influences the manner in which cultural structures formalize social interactions and how this might be related to what is considered mental illness. That is, a society that has more individuals who are prone to anxiety may develop different forms of social interaction than one that does not. Not only can the environment influence genetics, but genetics can also influence culture. This work is just beginning to be applied to viewing psychopathology from a cultural standpoint.
Considering how a condition such as lactose tolerance is found in some groups of individuals around the world and not in others gives us additional insights into when this condition may have developed. Since lactose tolerance is not found throughout the world but is limited to particular groups, one would assume that it was not part of the human condition when humans migrated out of Africa some 100,000 years ago. We can ask similar questions in terms of psychopathology. One question might be how long, in terms of our human history, a particular psychopathology has existed.
Let’s take schizophrenia as an example. A WHO study examined the presence of schizophrenia in a number of countries with very different racial and cultural backgrounds (Sartorius et al., 1986). If schizophrenia had an important environmental component, then you would expect to see different manifestations of the disorder in different cultures. Developed countries would show different rates from those of developing countries. Areas with different climates might also show differences, as is the case with multiple sclerosis. What these authors found was that, despite the different cultural and racial backgrounds surveyed, the experience of schizophrenia was remarkably similar across countries. Likewise, the risk of developing schizophrenia was similar in terms of total population presence—about 1%. Further, the disorder had a similar time course in its occurrence, with its characteristics first being seen in young adults.
The evolutionary and cultural perspectives help us ask questions such as what function a disorder might serve, as well as how it came about. For example, humans fear animals they have little contact with but do not fear more likely causes of danger such