The publication of the Cultural Formulation Outline in the DSM-IV represented a significant event in the history of standard diagnostic systems. It was the first systematic attempt at placing cultural and contextual factors as an integral component of the diagnostic process. The year was 1994 and its coming was ripe since the multicultural explosion due to migration, refugees and globalization impact on the ethnic composition of the U.S. population made it compelling to strive for culturally attuned psychiatric care. Understanding the limitations of a dry symptomatological approach in helping clinicians grasp the intricacies of the experience, presentation and course of mental illness, the NIMH Group on Culture and Diagnosis proposed to appraise, in close collaboration with the patient, the cultural framework of patients' identity, illness experience, contextual factors, and clinician-patient relationship, and to narrate this along the lines of five major domains. By articulating the patient's experience and the standard symptomatological description of a case, the clinician may be better able to arrive at a more useful understanding of the case for clinical care purposes. Furthermore, attending to the context of the illness and the person of the patient may additionally enhance understanding of the case and enrich the data base from which effective treatment can be planned.

Since the 1970s, understanding of the effects of trauma, including flashbacks and withdrawal, has become widespread in the United States. As a result Americans can now claim that the phrase posttraumatic stress disorder (PTSD) is familiar even if the American Psychiatric Association's criteria for diagnosis are not. As embedded as these ideas now are in the American mindset, however, they are more widely applicable, this volume attempts to show, than is generally recognized. The essays in Culture and PTSD trace how trauma and its effects vary across historical and cultural contexts. Culture and PTSD examines the applicability of PTSD to other cultural contexts and details local responses to trauma and the extent they vary from PTSD as defined in the American Psychiatric Association's Diagnostic and Statistical Manual. Investigating responses in Peru, Indonesia, Haiti, and Native American communities as well as among combat veterans, domestic abuse victims, and adolescents, contributors attempt to address whether PTSD symptoms are present and, if so, whether they are a salient part of local responses to trauma. Moreover, the authors explore other important aspects of the local presentation and experience of trauma-related disorder, whether the Western concept of PTSD is known to lay members of society, and how the introduction of PTSD shapes local understandings and the course of trauma-related disorders. By attempting to determine whether treatments developed for those suffering PTSD in American and European contexts are effective in global settings of violence or disaster, Culture and PTSD questions the efficacy of international responses that focus on trauma. Contributors: Carmela Alcantara, Tom Ball, James K. Boehnlein, Naomi Breslau, Whitney Duncan, Byron J. Good, Mary-Jo DelVecchio Good, Jesse H. Grayman, Bridget M. Haas, Devon E. Hinton, Erica James, Janis H. Jenkins, Hanna Kienzler, Brandon Kohrt, Roberto Lewis-Fernandez, Richard J. McNally, Theresa D. O'Nell, Duncan Pedersen, Nawaraj Upadhaya, Carol M. Worthman, Allan Young.

Psychiatric classifications created in one culture may not be as universal as we assume, and it is difficult to determine the validity of a classification even in the culture in which it was created. "Culture and Panic Disorder" explores how the psychiatric classification of panic disorder first emerged, how medical theories of this disorder have shifted through time, and whether or not panic disorder can actually be diagnosed across cultures.
In this breakthrough volume a distinguished group of medical and psychological anthropologists, psychiatrists, psychologists, and historians of science provide ethnographic insights as they investigate the presentation and generation of panic disorder in various cultures. The first available work with a focus on the historical and cross-cultural aspects of panic disorders, this book presents a fresh opportunity to reevaluate Western theories of panic that were formerly taken for granted.

Since the 1970s, understanding of the effects of trauma, including flashbacks and withdrawal, has become widespread in the United States. As a result Americans can now claim that the phrase posttraumatic stress disorder (PTSD) is familiar even if the American Psychiatric Association's criteria for diagnosis are not. As embedded as these ideas now are in the American mindset, however, they are more widely applicable, this volume attempts to show, than is generally recognized. The essays in Culture and PTSD trace how trauma and its effects vary across historical and cultural contexts. Culture and PTSD examines the applicability of PTSD to other cultural contexts and details local responses to trauma and the extent they vary from PTSD as defined in the American Psychiatric Association's Diagnostic and Statistical Manual. Investigating responses in Peru, Indonesia, Haiti, and Native American communities as well as among combat veterans, domestic abuse victims, and adolescents, contributors attempt to address whether PTSD symptoms are present and, if so, whether they are a salient part of local responses to trauma. Moreover, the authors explore other important aspects of the local presentation and experience of trauma-related disorder, whether the Western concept of PTSD is known to lay members of society, and how the introduction of PTSD shapes local understandings and the course of trauma-related disorders. By attempting to determine whether treatments developed for those suffering PTSD in American and European contexts are effective in global settings of violence or disaster, Culture and PTSD questions the efficacy of international responses that focus on trauma. Contributors: Carmela Alcantara, Tom Ball, James K. Boehnlein, Naomi Breslau, Whitney Duncan, Byron J. Good, Mary-Jo DelVecchio Good, Jesse H. Grayman, Bridget M. Haas, Devon E. Hinton, Erica James, Janis H. Jenkins, Hanna Kienzler, Brandon Kohrt, Roberto Lewis-Fernandez, Richard J. McNally, Theresa D. O'Nell, Duncan Pedersen, Nawaraj Upadhaya, Carol M. Worthman, Allan Young.

Biomedicine is often thought to provide a scientific account of the human body and of illness. In this view, non-Western and folk medical systems are regarded as systems of 'belief' and subtly discounted. This is an impoverished perspective for understanding illness and healing across cultures, one that neglects many facets of Western medical practice and obscures its kinship with healing in other traditions. Drawing on his research in several American and Middle Eastern medical settings, in this 1993 book Professor Good develops a critical, anthropological account of medical knowledge and practice. He shows how physicians and healers enter and inhabit distinctive worlds of meaning and experience. He explores how stories or illness narratives are joined with bodily experience in shaping and responding to human suffering and argues that moral and aesthetic considerations are present in routine medical practice as in other forms of healing.

Medicine supposedly offers a scientific account of the human body and of illness, and it follows that scientific medicine treats all forms of folk medicine as little more than superstitious practices. Professor Good argues that this impoverished perspective neglects many facets of Western medical practice and obscures its kinship with healing in other traditions. Drawing on his own anthropological research in America and the Middle East, his analysis of illness and medicine explores the role of cultural factors in the experience of illness and the practice of medicine.

Psychiatric classifications created in one culture may not be as universal as we assume, and it is difficult to determine the validity of a classification even in the culture in which it was created. "Culture and Panic Disorder" explores how the psychiatric classification of panic disorder first emerged, how medical theories of this disorder have shifted through time, and whether or not panic disorder can actually be diagnosed across cultures.
In this breakthrough volume a distinguished group of medical and psychological anthropologists, psychiatrists, psychologists, and historians of science provide ethnographic insights as they investigate the presentation and generation of panic disorder in various cultures. The first available work with a focus on the historical and cross-cultural aspects of panic disorders, this book presents a fresh opportunity to reevaluate Western theories of panic that were formerly taken for granted.

Some of the most innovative and provocative work on the emotions and illness is occurring in cross-cultural research on depression. Culture and Depression presents the work of anthropologists, psychiatrists, and psychologists who examine the controversies, agreements, and conceptual and methodological problems that arise in the course of such research. A book of enormous depth and breadth of discussion, Culture and Depression enriches the cross-cultural study of emotions and mental illness and leads it in new directions. It commences with a historical study followed by a series of anthropological accounts that examine the problems that arise when depression is assessed in other cultures. This is a work of impressive scholarship which demonstrates that anthropological approaches to affect and illness raise central questions for psychiatry and psychology, and that cross-cultural studies of depression raise equally provocative questions for anthropology.

Chronic pain challenges the central tenet of biomedicine: that objective knowledge of the human body and mind is possible apart from subjective experience and social context. Sufferers, finding that chronic pain alters every aspect of life, often become frustrated and distrust a profession seemingly unable to explain or effectively treat their illness. The authors of this innovative volume offer an entirely different, ethnographic approach, searching out more effective ways to describe and analyze the human context of pain.
How can we analyze a mode of experience that appears to the pain sufferer as an unmediated fact of the body and is yet so resistant to language? With case studies drawn from anthropological investigations of chronic pain sufferers and pain clinics in the northeastern United States, the authors explore the great divide between the culturally shaped language of suffering and the traditional language of medical and psychological theorizing. They argue that the representation of experience in local social worlds is a central challenge to the human sciences and to ethnographic writing, and that meeting that challenge is also crucial to the refiguring of pain in medical discourse and health policy debates.
Anthropologists, scholars from the medical social sciences and humanities, and many general readers will be interested in "Pain as Human Experience," In addition, behavioral medicine and pain specialists, psychiatrists, and primary care practitioners will find much that is relevant to their work in this book.