Culture, salience, and psychiatric diagnosis: exploring the concept of cultural congruence & its practical application.

Journal: Philosophy, ethics, and humanities in medicine : PEHM

Volume: 8

Issue: 

Year of Publication: 2014

Affiliated Institutions:  Department of Psychiatry, Division of Philosophy and Ethics of Mental Health, University of Pretoria, South Africa. m.rashed@alumni.ucl.ac.uk

Abstract summary 

Cultural congruence is the idea that to the extent a belief or experience is culturally shared it is not to feature in a diagnostic judgement, irrespective of its resemblance to psychiatric pathology. This rests on the argument that since deviation from norms is central to diagnosis, and since what counts as deviation is relative to context, assessing the degree of fit between mental states and cultural norms is crucial. Various problems beset the cultural congruence construct including impoverished definitions of culture as religious, national or ethnic group and of congruence as validation by that group. This article attempts to address these shortcomings to arrive at a cogent construct.The article distinguishes symbolic from phenomenological conceptions of culture, the latter expanded upon through two sources: Husserl's phenomenological analysis of background intentionality and neuropsychological literature on salience. It is argued that culture is not limited to symbolic presuppositions and shapes subjects' experiential dispositions. This conception is deployed to re-examine the meaning of (in)congruence. The main argument is that a significant, since foundational, deviation from culture is not from a value or belief but from culturally-instilled experiential dispositions, in what is salient to an individual in a particular context.Applying the concept of cultural congruence must not be limited to assessing violations of the symbolic order and must consider alignment with or deviations from culturally-instilled experiential dispositions. By virtue of being foundational to a shared experience of the world, such dispositions are more accurate indicators of potential vulnerability. Notwithstanding problems of access and expertise, clinical practice should aim to accommodate this richer meaning of cultural congruence.

Authors & Co-authors:  Rashed Mohammed Abouelleil MA

Study Outcome 

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Statistics
Citations :  APA (American Psychiatric Association) Diagnostic and statistical manual of mental disorders. 4. New York: APA; 1994.
Authors :  1
Identifiers
Doi : 10.1186/1747-5341-8-5
SSN : 1747-5341
Study Population
Male,Female
Mesh Terms
Cognition
Other Terms
Study Design
Phenomenological Study,Cross Sectional Study
Study Approach
Country of Study
Publication Country
England