Cultural contexts heavily influence the understanding and expression of mental distress. Across various cultures, actions labeled as pathological may hold spiritual significance, creating divergence with Western diagnostic frameworks like DSM and ICD. For instance, the Xhosa view of hearing voices contrasts with Western perceptions of schizophrenia. Furthermore, standardized diagnostic tools often miss culturally specific syndromes, complicating the mental health narrative. As such, recognizing these cultural nuances and favoring the concept of impairment can lead to more inclusive mental health care practices.
Behaviors labeled as pathological in one culture may be seen as spiritual or moral in another. Among the Xhosa in South Africa, hearing voices can be understood as ancestral communication rather than a symptom of schizophrenia.
Standardized diagnostic tools like DSM-5-TR and ICD-11 rely on polythetic symptom lists that require individuals to meet a subset of criteria, which often overlooks culturally specific expressions of distress.
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