How does Cross-cultural Psychology Influence or Contribute Applications in Health Care?

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How does CCP Influence or Contribute Applications
in Health Care?

• PRESENTATION

• Cross-Cultural Psychology

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CONTENT

• Cross-Cultural Psychology and Health
• Illness relate to Large-scale Culture
• Mental Disorders
• Temperament Dimensions
• Thailand versus the United States
• Attention Deficit Disorder (ADD)
• Two Theoretical Frameworks
• The ecocultural niche framework developed by
  Weisner and his colleagues (Weisner, 1984
  Weisner, Matheson, Bernheimer, 1986)
• The developmental niche framework developed by
  Super and Harkness (1986a)
• References

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Cross-Cultural Psychology and Health
01.

• Contributions of Cross-Cultural Psychology to
  Research and Interventions in Health

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Illness relate to Large-scale Culture

• Cross-cultural psychologists have provided new
  knowledge about the cultural distribution of
  illness and health-seeking behavior
• E.g., the illness beliefs among Chinese, Indian,
  and Anglo Celtic Canadians (Cook, 1994) showed
  cultural variability subscribed to biomedical,
  psychosocial, and phenomenological beliefs about
  chronic illness, which were related to health
  care seeking
• Additionally, illness has documented in
  prevalence in various cultures
• E.g., adolescent eating disorders have been
  diagnosed due to the Western society focused on
  thin figure among women
• These disorders are also diagnosed in non-Western
  cultures (Lee, 1995)
• These changes in the prevalence of illness relate
  to large-scale culture change and the emergence
  of a transnational culture of modernity (Harkness
  Keefer, 2000)

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Mental Disorders

• The universality versus cultural specificity of
  mental disorders has been a great debated
  (Harkness Keefer, 2000)
• Psychopathology was concluded that cultural
  factors have a quantitative, but not qualitative
  influence on psychiatric symptoms (Draguns, 1997)
• On the other hand, cultural meaning systems are
  indicated with many aspects of illness and health
  (Harkness Super, 2000)
• E.g., depression is a universally recognized
  disorder (Marsella, Sartorius, Jablensky,
  Fenton, 1985)
• Symptoms of lack of appetite and difficulty
  sleeping predominating in non European patients
• Symptoms of sadness and feelings of worthlessness
  in Western patients

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Temperament Dimensions

• Genetically based population differences in some
  aspects of temperament like approach or
  withdrawal and threshold of response to external
  stimuli or events, the physiology of temperament
  points to culturally universal dimensions (Kagan,
  Resnick, Snidman, 1987)
• Given this largely shared human heritage,
  cultural variability in parental reports of child
  behavior related to temperament (Super
  Harkness, 1986b)
• The childs developmental niche is shaped to
  encourage or discourage particular temperamental
  dispositions
• Based on a study of Japanese mothers
  descriptions of their infants temperaments, five
  culturally specific temperament dimensions were
  identified to reflect the nature of Japanese
  mother-infant relationships (Shwalb, Shwalb,
  Shoji, 1996)
• E.g., the sociability factor and a factor
  representing responsiveness to physical contact
  suggest a positive and close relationship between
  the mother and infant

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• The Japanese temperament research is another
  issues in health
• Western theories as cultural productions
• Western health care practices as culturally
  constructed
• Temperament constructs based on research among
  Western populations are themselves a type of
  ethnotheory (Shwalb et al., 1996)
• As such, these cultural beliefs inform (Harkness
  Keefer, 2000)
• The ways parents think about their children
• Clinical approaches to the understanding of
  individual differences among children
• The culture of medicine are linked with
  variability in diagnosis that goes beyond actual
  population differences (Beardsley, 1994)
• Figuring differences in perception among parents
  and professionals and differences in actual
  patterns of disorder are complicated (Weisz,
  McCarty, Eastman, Chaiyasit, Suwanlert, 1997)

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Thailand versus the United States

• In a comparison study of the prevalence of child
  and adolescent behavior disorders in Thailand and
  the United States, parent reports of childrens
  overcontrolled problems and undercontrolled
  problems were quite similar, but a stronger
  contrast in clinical referrals
• The Thai parents reported more overcontrolled
  problems (e.g., shyness, somaticizing, and
  depression)
• The American parents reported more
  undercontrolled problems (e.g., disobedience,
  fighting, and impulsivity)
• Teacher reports showed a prevalence rate of
  behavior problems in Thailand that was double the
  rate of American children, but cross-cultural
  observers found exactly the opposite
• Such reports are strongly influenced by
  culturally shared ideas about what kind of
  behavior is appropriate for children of certain
  ages (Harkness Keefer, 2000)

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Attention Deficit Disorder (ADD)

• The case of ADD shows an issue in contemporary
  U.S. health care for the alternative to the
  predominant medical model
• The National Institutes of Health Consensus
  Conference did not make any basis for this
  disorder in brain functioning, ADHD is diagnosed
  among American children with rapidly increasing
  frequency, as indexed by a 500 increase in
  producing Ritalin (medicine) from 1990 to 1995
  (Diller, 1996)
• Its definitions of common behaviors (for boys)
  like not paying attention when spoken to,
  forgetting or not finishing school assignments,
  and not staying seated when it is appropriate in
  medical term
• Being hyperactivity is not a disease of the
  child, but rather the depersonalisation of social
  processes which result in labelling as sick for
  children who behave badly (Rubenstein Perloff,
  1986)
• Although comparisons of the trend of
  hyperactivity are difficult due to the diagnostic
  issues, both the culture of medicine and the
  popular culture in the United States have created
  a new diagnostic entity in ADHD (Harkness
  Keefer, 2000)

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Two Theoretical Frameworks
02.

• Both reflect the seminal influence of John and
  Beatrice Whitings cross-cultural research on
  child rearing and more new ideas from psychology
  and ecology (Harkness Keefer, 2000)

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The Ecocultural Niche Framework

• This model was developed by Weisner (1984) and
  Weisner et al. (1996)
• Emphasizes family adaptation in the construction
  of sustainable daily routines
• Considers the external factors that influence the
  familys ability to adapt successfully
• This model has been used to examine
• Issues including family interventions, the home
  school interface, and families with
  developmentally delayed children
• If early recognition of developmental delays
  could improved outcomes for the children, as
  assumed by American health care providers
  (Weisner et al., 1996)

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• Such early recognition did not show great results
  among California families, because American
  middle-class families is optimally organized to
  foster the child development, including those
  with disabilities
• In a recent application, family responses to an
  innovative program of support for the transition
  from welfare to work can merge into existing
  family routines on a continuing basis (Weisner,
  Bernheimer, Gibson, Hoard, Magnuson, Romich,
  1999)
• This model also focuses on activity like the
  locus for contextual influence within the larger
  framework of adaptation at the group level
• A study of Hawaiian childrens activity at home
  and performance at school developed
  child-generated classroom learning activities
  that was more successful than traditional,
  teacher-directed activities (Weisner, Gallimore,
  Jordan, 1988)
• In these examples, this theoretical framework
  shaped the research design to discover
  opportunities for effective intervention
  (Harkness Keefer, 2000)

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The Developmental Niche Framework

• The developmental niche framework elaborated by
  Super and Harkness (1986a, 1998) focuses on the
  culturally organized contexts of child
  development, including daily life, customs and
  practices of child care, and the psychology of
  the caretakers.
• This framework has been used to analyze many
  aspects of child development and health in
  cultural context (Harkness Super, 1994, 2000
  Super, Keefer, Harkness, 1994).
• This framework was used to examine cultural
  variability within the Western world in (Harkness
  Super, 2000)
• How parents think about their childrens
  development
• How they organize childrens learning
  environments at home
• How the developmental niche at home relates to
  its counterpart at school, as illustrated by the
  research on Dutch and American parents

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• In other research, it was used to examine the
  development of sleep and wake patterns in
  infancy,
• Suggesting that American parents ethnotheories
  and customs of care of development, which
  emphasize the importance of cognitive stimulation
• May make it difficult for infants to build early
  patterns of regular night time sleep (Super,
  Harkness, van Tijen, van der Vlugt, 1996)
• An international application analyzed patterns of
  diarrheal disease and growth stunting among
  infants and young children in rural Bangladesh
  (Zeitlin, Ahmed, Beiser, Zeitlin, Super,
  Guldan, 1995)
• Variability related to season and to the childs
  age are connected to the interaction of the
  environmental risk and the childs developmental
  capacities (e.g. crawling on contaminated dirt
  floors) in the context of care guided by parental
  ethnotheories
• As with the ecocultural niche model, this
  analysis offered a basis for the design of
  interventions to enhance child health (Harkness
  Keefer, 2000)

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References

• Beardsley, L. M. (1994). Chapter 40 Medical
  diagnosis and treatment across cultures. PDF
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• Cook, P. (1994). Chronic illness beliefs and the
  role of social networks among Chinese, Indian,
  and Angloceltic Canadians. Journal of
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• Diller L. H. (1996). The run on Ritalin.
  Attention deficit disorder and stimulant
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• Draguns, J. G. (1997). Abnormal behavior patterns
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References

• Harkness, S., Super, C. M. (2000). Culture and
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References

• Shwalb, D. W., Shwalb, B. J., Shoji, J. (1996).
  Japanese mothers ideas about infants and
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• Super, C. M., Harkness, S. (1986a). The
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• Super, C. M., Harkness, S. (1986b).
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• Super, C. M., Harkness, S., van Tijen, N., van
  der Vlugt, E. (1996). The three Rs of Dutch
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References

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References

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