Monday, 20 October 2014

Abstract on transcultural psychiatry

For personal reasons, my mind is fogged at the moment and whole draft papers, approaching completion, seem to be stuttering towards their ends. And hence I think I need to write a series of fresh abstracts to help me tighten and commit to them. So here is the first for a chapter on transcultural psychiatry.

DSM-5 introduces an emphasis on non-Western cultural idioms of mental distress but without making explicit the relation between these and the psychiatric scientific aspirations, such as for their reliability and validity, of the rest of the taxonomy. This paper outlines three possible views of the nature of transcultural psychiatric taxonomic concepts which would render them different from but not incompatible with the rest of the taxonomy. But I argue in the second section that establishing the correctness of any one is none too easy. Two influential approaches to the nature of the concept of disorder – Wakefield’s harmful dysfunction analysis and Fulford’s failure of ordinary doing – can be pressed, with merely minor tweaking, to support any of the a priori models of transcultural concepts. In the final section I examine one such idiom: khyal attacks or khyal cap or wind attacks, a syndrome found among Cambodians. I argue that this does not fit any of the ways of ‘domesticating’ variation from standard DSM-5 categories and that this suggests that the very idea of transcultural psychiatric diagnostic concepts fits uneasily with the rest of DSM-5.