Chapter

Culture

Bill (KWM) Fulford, Katherine Morris, John Z Sadler and Giovanni Stanghellini

in Values and Psychiatric Diagnosis

Published on behalf of Oxford University Press

Published in print October 2004 | ISBN: 9780198526377
Published online March 2013 | e-ISBN: 9780191754357 | DOI: http://dx.doi.org/10.1093/med/9780198526377.003.0007

Series: International Perspectives in Philosophy & Psychiatry

Culture

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A discussion of values and culture in mental disorder classification should probably be introduced by considering the range of values-related issues. One such evaluative perspective is the relative weight that cross-cultural considerations should play when building DSM or ICD classifications of mental disorders. A second perspective involves how the Western, North American culture contributes to the background evaluative assumptions of the DSMs (or ICDs for that matter). A third might consider how culture affects the interpretation and use of a diagnostic manual for mental disorders. A fourth might consider how cultural values constrain the development, approval, and use of a diagnostic manual. A fifth perspective might consider the ethics of cross-cultural psychiatric diagnosis. A sixth might even seek to frame this book’s considerations as an expression of Western cultural values. I m sure I m overlooking some other possibilities … The point here is to suggest that considerations of culture in mental disorder classification can cut as wide, indeed a wider, swath than the ’mere ambitions of developing a value-analysis of mental disorder classification. Because of the breadth and depth of the culture issues, I must limit my own discussions here — hopefully in promising directions. The general thrust of this chapter is (1) to sketch out what I see as the fundamental problem(s) of culture in psychiatric classification; (2) to review briefly the considerable work that has been done in culture and psychiatric diagnosis with an eye towards some of the value considerations discussed in the first paragraph; (3) to consider what I think is a neglected, values-related dimension in considerations of cross-cultural DSM development and use; (4) to discover and illustrate a novel aesthetic value that might aid in the editing of future DSM and ICD developments; and (5) to consider briefly some of the ethics involved in psychiatric classification across cultures. Composing this list is daunting enough — let’s get on with it!

Chapter.  17700 words. 

Subjects: Psychiatry

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