Perceptions of problematic behavior by Appalachians, mental health professionals, and lay non-Appalachians.

This study postulated that the culture of a group influences the labels that group places on behavior. In the case of problematic behaviors, culture influences whether the behaviors are labeled mental illness. Three groups of randomly selected respondents representing two cultural groups were interviewed to compare the labels placed on problematic behavior. One group represented the Appalachian culture (N = 50). Two groups represented the predominant American culture: mental health professionals (N = 54) and a lay group or non-Appalachians (N = 50). Each respondent was interviewed personally, using a structured questionnaire consisting of vignettes that described various problematic behaviors. It was hypothesized that there would be a significant difference between cultural groups in the labeling of problematic behaviors. Data were analyzed by a oneway analysis of variance, and a qualitative analysis was done. Findings supported the hypothesis. No significant differences were found between the mental health professionals and the lay group of non-Appalachians; however, there was a significant difference between each of these groups and the Appalachians. Behaviors that were labeled as mental illness by the mental health professionals and the lay non-Appalachians were labeled as lazy, mean, immoral, criminal, or psychic by the Appalachians. Kinds of management recommended for these behaviors by the two cultural groups differed. Whereas mental health professionals and lay non-Appalachians recommended some type of psychiatric management, Appalachians recommended punishment by either the social group or the legal system, or they recommended that the behaviors be tolerated.