Guarnaccia P J, Rogler L H
Rutgers University, NJ, USA.
Am J Psychiatry. 1999 Sep;156(9):1322-7. doi: 10.1176/ajp.156.9.1322.
The unprecedented inclusion of culture-bound syndromes in DSM-IV provides the opportunity for highlighting the need to study such syndromes and the occasion for developing a research agenda to study them. The growing ethnic and cultural diversity of the U.S. population presents a challenge to the mental health field to develop truly cross-cultural approaches to mental health research and services. In this article, the authors provide a critique of previous analyses of the relationship between culture-bound syndromes and psychiatric diagnoses. They highlight the problems in previous classificatory exercises, which tend to focus on subsuming the culture-bound syndromes into psychiatric categories and fail to fully investigate these syndromes on their own terms. A detailed research program based on four key questions is presented both to understand culture-bound syndromes within their cultural context and to analyze the relationship between these syndromes and psychiatric disorders. Results of over a decade of research on ataques de nervios, a Latino-Caribbean cultural syndrome, are used to illustrate this research program. The four questions focus on the nature of the phenomenon, the social-cultural location of sufferers, the relationship of culture-bound syndromes to psychiatric disorders, and the social and psychiatric history of the syndrome in the life course of the sufferer.
《精神疾病诊断与统计手册》第四版（DSM-IV）破天荒地纳入了文化相关综合征，这为强调研究此类综合征的必要性提供了契机，也为制定研究议程以对其展开研究创造了条件。美国人口中日益增长的种族和文化多样性给心理健康领域带来了挑战，促使其开发真正跨文化的心理健康研究与服务方法。在本文中，作者对先前关于文化相关综合征与精神疾病诊断之间关系的分析进行了批判。他们强调了先前分类工作中存在的问题，这些问题往往侧重于将文化相关综合征归入精神疾病类别，而未能按照其自身特点对这些综合征进行充分研究。本文提出了一个基于四个关键问题的详细研究计划，旨在从文化背景中理解文化相关综合征，并分析这些综合征与精神疾病之间的关系。作者运用了对拉丁裔加勒比文化综合征“ataques de nervios”长达十多年的研究结果来阐释这一研究计划。这四个问题聚焦于该现象的本质、患者的社会文化定位、文化相关综合征与精神疾病的关系，以及该综合征在患者生命历程中的社会和精神病史。
