Protein-energy malnutrition as a culture-bound syndrome.

A new definition of the concept of culture-bound syndrome demonstrates that culture-boundedness is common and applies as well to Western biomedical disease categories as to nonWestern categories. Culture-boundedness is important when a common disorder with a large sociopsychological component is frequently treated, but unsuccessfully. To improve intervention success, therapists must recognize and accept that clients and interventionists may employ widely dissimilar culture-bound explanatory models. Therapists must learn to synthesize among models, neither rejecting nor discounting those of clients. The fact that Western notions of cause are culture-bound has gone largely unrecognized because of the tendency among biomedical scientists to treat science as if it were culture-free and universally comprehensible. This is of course a naive and invalid understanding. These points are illustrated for the case of protein-energy malnutrition. If those who design and facilitate intervention to alleviate hunger can come to understand that the scientific explanatory model of protein-energy malnutrition is only one among several cogent models, they will be in a strong position to understand intervention failure and possibly to overcome it.