Culture, Medicine, and Psychiatry

This paper examines a statistics debate among African American caregivers raising children with disabilities for insights into the work of “African American mothering.” Using ethnographic, narrative and discourse analyses, we delineate the work that African American mothers do—in and beyond this conversation—to cross ideological and epistemological boundaries around race and disability. Their work entails choosing to be an “I” and, in some cases, actively resisting being seen as a “they” and/or part of a collective “we” in order to chart alternative futures for themselves and their children.

The prominence of co-morbidity in children and adolescents has increased over the past decade as new empirical research data has accumulated. Yet little epidemiological data of any kind exists for First Nations Children. Following a brief literature review on co-morbidity in children and adolescents, the authors analyzed data from the Flower of Two Soils Project (M. Beiser, principal investigator) to examine more closely the relationship between self-reported depressive symptoms and parent/teacher reported conduct symptoms. Such a relationship has been consistently found in a number of studies. Children aged 7 to 10 were found to show more academic and social problems when rated as having high conduct symptoms. Children in the co-morbid group were found to have the highest rates of family stress and help-seeking behavior. Suicidal ideation was as high in the conduct and co-morbid groups as it was in the high depression group. More First Nations children were found in the high conduct-low depression group. The significance of these findings is discussed.

In highland Ecuador, pena refers to a state of mind characterized by a mixture of sadness and anxiety as well as to an illness state resembling depression. This paper attempts to illustrate, through an analysis of the discourse on pena, how the ideology in which it is embedded serves to interpret a bodily problem at the same time as it reflects a more global attitude toward life. In essence, the folk theory states that the physical complaints caused by suffering are the result of a disturbance of the heart, the central organ of man, and of the emotional life which it controls. Because this suffering is often attributed to the immediate family group of the victim, the community at large often formulates accusations against one of its members. Though the therapy is limited to a cure of the symptoms through herbal remedies, a formal request can be made to a perceived wrongdoer to amend his behavior. The pena is also a state which can lead to colerin, a dangerous and sometimes lethal illness which is characterized by a sudden explosion of anger or madness and which will follow an unattended state of pena.

This article addresses conflicting concerns related to space for mourning in Norway. It draws on material from qualitative interviews with bereaved parents who have lost a child in stillbirth. Space for mourning, and the need for sick leave, arose as a crucial concern and complex issue in these interviews. Although initiatives have been developed to introduce grief as a valid category in diagnostic repertoires, it is not a legitimate basis for sick leave in the acute phase. Common alternatives have been referrals to psychic instability or depression. Both variations represent a medicalization of the normal with implications that need to be addressed, and which this article discusses from the bereaved parents’ point of view. Extended parental leave, and the introduction of grief allowance, are possible alternatives for the provision of space in normal but demanding times of grief. Despite not yet part of the repertoire for gatekeepers in the Norwegian welfare state, they are part of the public discourse. Besides a crucial acknowledgment of the grief of the parents, these options also represent possibilities for preventing a pathologization of what is a normal rite of passage.

Despite the increasing use ofreproductive technologies the world over,anthropological studies have paid remarkablylimited attention to the ethical dilemmasinvolved in people's choices of suchtechnologies. Against this background, theauthor analyzes moral perceptions of inducedabortion among unmarried young adults in urbanNorth Vietnam. While the ethical aspects ofabortion are shrouded in silence in public lifein Vietnam, the young people participating inthe study expressed strong moral scepticismtowards the practice of abortion, even whileundergoing it themselves. Through the analysisof young people's experiences and perceptions,the paper demonstrates how moral ideas are tiedto particular social situations and structuredby larger socio-political circumstances. It isargued that moral notions which are dominant ina society's public sphere may not berepresentative of the moral sentiments that arelived in practice and felt in private.

Koro is generally considered a culture-bound psychiatric syndrome, the dominant feature of which is anxiety or dissociation. A close examination of koro epidemics in China, where koro cases appear to be more frequent than other parts of the world, shows that koro has a sociocultural component which has not been sufficiently taken into account in previous formulations. This article analyzes koro in the natural environment in which it appears and dispels the notion of koro being individual psychopathology. Koro, at least the way it is manifested in China, is a social malady maintained by cultural beliefs which affect the whole community and not just those diagnosed with it. Future directions for research into the subject are discussed.