Background: A short version of the Posttraumatic Diagnostic Scale comprising only re-experiencing symptom items has been recently validated on Japanese adults. This short-version-PDS had good psychometric properties among Japanese adults with and without posttraumatic stress disorder. The aim of this study was to translate and culturally validate the short-version-PDS for the Brazilian sociolinguistic context.Methods: A translation of the short-version-PDS was performed based on established guidelines. We enrolled 53 patients with PTSD as a potential comorbidity. The translation and cross-cultural (...) adaptation of the short-version-PDS included forward and back-translation by a Japanese Brazilian researcher and a certified translator; synthesis was achieved by consensus, backward translation, pilot test, and finalization. Content validity coefficient was used to assess quality of adaptation. Internal consistency was calculated using Cronbach's alpha coefficient. Spearman correlations were between the new short-version-PDS and the Brazilian version of the posttraumatic Stress Disorder Checklist for DSM-5, and a receiver operating characteristic curve was used to determine the best cut-off values for the short-version-PDS.Results: The short-version-PDS was well accepted by all subjects, none of the questions were experienced as inappropriate, and all questions of the 3 items were judged important. Item 1 presented CVCt = 0.92; item 2 had a CVCt = 0.87 and item 3 had a CVCt = 0.95. The internal consistency of the final version as measured by Cronbach's alpha was 0.78. The short-version-PDS scale correlated positively with the DSM-5 scale with a Spearman rho of 0.64 (95%CI [0.4-0.8], p 31.0 with sensitivity and specificity are 86.4 and 93.5%, respectively.Conclusions: This Brazilian Portuguese version of the short-version-PDS had good psychometric properties among Brazilian adults with and without PTSD. Transferability and generalizability of the cut-off scores should be further analyzed. (shrink)

This article examines the revision of the Diagnostic and Statistical Manual of Mental Disorders and its claim of incorporating a “greater cultural sensitivity.” The analysis reveals that the manual conveys mixed messages as it explicitly addresses the critique of being ethnocentric and having a static notion of culture yet continues in a similar fashion when culture is applied in diagnostic criteria. The analysis also relates to current trends in psychiatric nosology that emphasize neurobiology and decontextualize distress and (...) points to how the DSM-5 risks serving as an ethnic dividing line in psychiatry by making sociocultural context relevant only for some patients. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Diagnostic WannabesJennifer Radden, PhD (bio)Saunders explores challenges for the clinician faced with self-styled sufferers from attention deficit hyperactivity disorder, post-traumatic stress disorder, bipolar disorder, autism spectrum disorder (ASD), and fibromyalgia. The diagnostic system was not meant to be used as “a scaffold for identity,” she points out. Yet wannabe patients now step into the clinic wielding self-proclaimed diagnoses as social identities. Saunders explains the context where such (...) phenomena arise, and offers guidelines for clinicians addressing this new reality. To do so, she enlists Rashed’s innovative normative approach to the so-called boundary problem of assigning, and providing justification for, the contested line between normal and disordered. The boundary problem itself seems to rise to prominence during our current era of increasingly dimensional thinking, it is worth noting, with psychiatric diagnoses taken to refer to points on a continuum, rather than to discrete categorical disease entities.On the likely sources of these ‘diagnostic’ social identities, as well as reasons why certain diagnoses attach to them more commonly than others, Saunders points to social trends (including what she asserts to be a “post-stigma” cultural environment), the failure of efforts to identify neurobiological markers for psychiatric disorder, the ubiquity of social media, the algorithms themselves, and the hyperconnected existence of contemporary times. Such narratives also offer the comforts of a sense of belonging and explanations for perceived inadequacies, she rightly observes.Despite today’s virtual and other inducements, the problem introduced here is not an entirely new one. The first part of the seventeenth century in Europe saw an apparent “epidemic” of what was known as “melancholy,” a condition associated with the spleen, whose symptoms loosely resembled those of today’s depression and anxiety. Much of this suffering was undeniably real, but much was a fashionable, identity-conferring pose. “Every distemper of the body now is complicated with spleen,” the poet John Donne ironically observes in a letter dated 1622, “and when we were young men we scarce ever heard of the spleen. In our declinations now, every accident is accompanied with heavy clouds of melancholy”1 (Gosse, 2019). By then, the Melancholic Man (or homo melancholicus), with his surfeit of spleen, was an unmistakable character type—or social identity, as we would now say. Recognized and saluted in centuries-long literary and illustrative traditions, the type was an anchoring element of the humoral medicine which, despite the gradual emergence of more empirical science, had endured since Galenic times.Melancholy’s closest descendants, affective depressive and anxiety disorders, are today less evident among the troubling identities Saunders discusses—somewhat preempted, she points out, by more cognitively-based diagnoses such as ASD. [End Page 279] This is itself an ironic reminder of the vagaries of cultural attitudes, cautioning us to remember the broader context where these particular social identities are selected for emulation and adoption.The lure of the melancholy man’s2 social identity is well understood: already normalized, within the humoral system in which excess black bile afflicted roughly one in four people, it had been valorized for centuries—arguably by Aristotelian writing (in the dubious ‘Problems’), during the Renaissance by Ficino, and Shakespeare—even by Freud in his 1916 ‘Mourning and Melancholia.’ Through most of Western history, the positive attributes and benefits of the dark moods of melancholy have needed no further explaining or justifying. They glow with glamorous associations.Applying Rashed’s conditions for appropriately acknowledging and recognizing the fit of a person’s chosen social identity, Saunders‘ guidance for clinicians clarifies boundary matters. And it illustrates how to understand, regulate and communicate the appropriate norms in ways that can dissuade those whose personal growth and mental health are not served by claiming such identities.With at least some of the popular social identities Saunders describes, I think we can helpfully continue the comparison with the homo melancholicus. For the ‘neurodiversity’ rhetoric of our own times contains forces promoting both the normalization and the valorization of syndromes such as ASD. Pointing to analogies with differences of gender, ethnicity and culture, neurodiversity theorizing argues for a respect for, and appreciation of, difference. Mental or cognitive variations are equally natural and valuable, it is... (shrink)

Cultural congruence is the idea that to the extent a belief or experience is culturally shared it is not to feature in a diagnostic judgement, irrespective of its resemblance to psychiatric pathology. This rests on the argument that since deviation from norms is central to diagnosis, and since what counts as deviation is relative to context, assessing the degree of fit between mental states and cultural norms is crucial. Various problems beset the cultural congruence construct including (...) impoverished definitions of culture as religious, national or ethnic group and of congruence as validation by that group. This article attempts to address these shortcomings to arrive at a cogent construct. (shrink)

This paper discusses how to apply a collective decision model of the principle of voluntary informed consent in African communitarian culture, in a culturally sensitive way, in order to protect research candidates from potential exploitations and abuses. Dismissing cultural and ethical skepticism surrounding the global application of the principle of voluntary informed consent, the paper ultimately concludes that international collaboration on diagnostic and therapeutic medical research in Africa, especially HIV vaccine trials, is a moral imperative.

The paper examines the ethical dimensions of Michel Houellebecq’s works of fiction. On the basis of keen diagnostics of contemporary Western culture, this world-renowned French writer predicts the destructive social consequences of ultra-liberalism and enters into an argument with transhumanist theories. His writings, depicting the misery of contemporary man and imagining a new human species enhanced by technologies, show that neither the so-called neo-humans nor the “last man” of liberal democracies can reach happiness. The latter can only be achieved if (...) humanist values, shared by previous generations and promoted by the great 19th-century authors (Balzac, Flaubert), are reinvented. (shrink)

The profession of medicine is predicated upon an ethical mandate: first do no harm. However, critics charge that the medical profession’s culture and its public health mission are being undermined by the pharmaceutical industry’s wide-ranging influence. In this article, we analyze how drug firms influence psychiatric taxonomy and treatment guidelines such that these resources may serve commercial rather than public health interests. Moving beyond a conflict-ofinterest model, we use the conceptual and normative framework of institutional corruption to examine how organized (...) psychiatry’s dependence on drug firms has distorted science. We suggest that academic-industry relationships have led to the corruption of the evidence base upon which accurate diagnosis and sound treatment depend. We describe the current dependency corruption and argue that transparency alone is not a solution — and sometimes even produces iatrogenic effects. Furthermore, we argue that the corruption of the evidence base for diagnostic and practice guidelines renders obsolete the traditional informed consent process, and we offer suggestions for reforming this process. (shrink)

In “Mad Narratives: Self-Constitutions Through the Diagnostic Looking Glass,” by using narrative approaches to the self, I explore how the diagnosis of mental disorder shapes personal identities and influences flourishing. My particular focus is the diagnosis grounded on the criteria provided by the Diagnostic Statistical Manual of Mental Disorders (DSM). I develop two connected accounts pertaining to the self and mental disorder. I use the memoirs and personal stories written by the subjects with a DSM diagnosis as illustrations (...) to bolster my claims. First, expanding on the narrative approaches to the self, I explain how narratives about a subject shape her self-constitution. I elucidate how this process is generated by drawing on research in developmental psychology, cognitive science, and social psychology. Next, using this account as a springboard, I argue that the DSM diagnosis of mental disorder serves as a source of narrative, entering into the patients’ autobiographical and social narratives. This plays an important role in the diagnosed subjects’ self-understanding, self-constitution and flourishing. In this vein, how mental disorders are classified is not only a theoretical question about accurately taxonomizing the various experiences related to mental distress but also an ethical question about which ways of talking about mental disorders will allow subjects to respond effectively to their psychological distress, to flourish and to live autonomous and fulfilling lives. Finally, I suggest that the DSM-based narratives wield a double-edged sword when it comes to the subject’s flourishing: On the one hand, there are problems with some DSM-based narratives that stem from the DSM diagnostic schema and the culture of DSM diagnoses. These problems render these DSM-based narratives unbeneficial for flourishing as they constrain the range of adoptive social, cognitive and emotional responses the subjects can give to their mental disorders. On the other hand, there are grounds to believe that some DSM-based narratives help subjects to flourish. For instance, they provide certainty to subjects' otherwise puzzling symptoms and help them reach out to others with similar experiences. Understanding how the DSM-based narratives can both benefit and harm will help us address problems with psychiatric diagnoses and the dissemination of knowledge about mental disorders in popular culture. The project aims to convince both philosophers and psychiatrists that no plausible theory of the self can be developed without attending to the topic of mental disorder and that no theory of mental disorder can be complete without devising the tools provided by the philosophical approaches to the self as well as developmental and social psychology. It also calls for methodological alterations in mental health ethics research, arguing that a careful scrutiny of mental disorder memoirs can advance the ethical underpinnings to the practice of psychiatry. (shrink)

Diagnostic terms in psychiatry like ‘schizophrenia’ and ‘bipolar disorder’ are deeply contested in the professional community, by mental health activists and the public. In this paper, we provide a theoretical framework for considering diagnostic terms as ordinary linguistic expressions and illustrate this approach by a corpus linguistic analysis of ‘schizophrenia.’ Our aim is to show how a focus on language itself can inform current and future debates about psychiatric terminology and provide new insights on relevant processes concerning their (...) actual usage and change over time. We hope that this contributes to enhancing mutual understanding between different discourse spheres and stakeholders. (shrink)

The Diagnostic and Statistical Manual (DSM) of the American Psychiatric Association, currently in its fourth edition and considered the reference for the characterization and diagnosis of mental disorders, has undergone various developments since its inception in the mid-twentieth century. With the fifth edition of the DSM presently in field trials for release in 2013, there is renewed discussion and debate over the extent of its relative successes - and shortcomings - at iteratively incorporating scientific evidence on the often ambiguous (...) nature and etiology of mental illness. Given the power that the DSM has exerted both within psychiatry and society at large, this essay seeks to analyze variations in content and context of various editions of the DSM, address contributory influences and repercussion of such variations on the evolving landscape of psychiatry as discipline and practice over the past sixty years. Specifically, we document major modifications in the definition, characterization, and classification of mental disorders throughout successive editions of the DSM, in light of shifting trends in the conceptualization of psychopathology within evolving schools of thought in psychiatry, and in the context of progress in behavioral and psychopharmacological therapeutics over time. We touch upon the social, political, and financial environments in which these changes took places, address the significance of these changes with respect to the legitimacy (and legitimization) of what constitutes mental illness and health, and examine the impact and implications of these changes on psychiatric practice, research, and teaching. We argue that problematic issues in psychiatry, arguably reflecting the large-scale adoption of the DSM, may be linked to difficulties in formulating a standardized nosology of psychopathology. In this light, we highlight 1) issues relating to attempts to align the DSM with the medical model, with regard to increasing specificity in the characterization of discrete mental disease entities and the incorporation of neurogenetic, neurochemical and neuroimaging data in its nosological framework; 2) controversies surrounding the medicalization of cognition, emotion, and behavior, and the interpretation of subjective variables as 'normal' or 'abnormal' in the context of society and culture; and 3) what constitutes treatment, enablement, or enhancement - and what metrics, guidelines, and policies may need to be established to clarify such criteria. (shrink)

This paper examines two topics in Japanese medical ethics: non-disclosure of medical information by Japanese physicians, and the history of human rights abuses by Japanese physicians during World War II. These contrasting issues show how culture shapes our view of ethically appropriate behavior in medicine. An understanding of cultural context reveals that certain practices, such as withholding diagnostic information from patients, may represent ethical behavior in that context. In contrast, nonconsensual human experimentation designed to harm the patient is (...) inherently unethical irrespective of cultural context. Attempts to define moral consensus in bioethics, and to distinguish between acceptable and unacceptable variation across different cultural contexts, remain central challenges in articulating international, culturally sensitive norms in medical ethics. (shrink)

For many, anger has been seen as irrationality, even as illness. But it seems that anger-related disorder and its culture-relatedness have not receive much attention in psychiatry. Like backward-looking ressentiment, hwabyeong 火病can be literally translated into anger disorder. In this paper, I examine the notion of anger and culture with the help of considering the case of hwabyeong as a Korean culture-bound syndrome (hereafter, CBS). Drawing on historical changes in the DSM (Diagnostic and Statistical Manual of Mental Disorders) and (...) cases of hwabyeong as CBS, I will argue that the social and cultural aspects of mental disorder are indispensable parts. Additionally, it will be suggested that the rigid distinction between CBS and mental disorders is questionable. First, I begin by examining Jarome Wakefield’s harmful dysfunction analysis and Ian Hacking’s social constructionism on mental disorder. Next, given that the illness is common among poor old women who suffered from patriarchal social structures, I question whether hwabyeong is really a culturally specific illness. Moreover, hwabyeong cannot be properly understood without considering unequal power relations and extremely limited ranges of one's agency. Thus, calling it culture- bound may be due to WEIRD-ish (Western, Educated, Industrialized, Rich, and Democratic), culturally stereotypical prejudice as well as misogynic thinking concerning hwabyeong. In present times, it's worth noting that, despite common biases, hwabyeong or han (恨) is no longer solely a Korean phenomenon, thanks to recent societal advancements. In conclusion, I show that curing hwabyeong or anger management is not just medical but sociopolitical matters. (shrink)

In this paper, I enquire into the nature of the influence culture has on the experience of trauma. I begin with a brief elaboration of the dominant conceptualisation of post-traumatic experiences: the diagnostic category of PTSD as it can be found in the DSM. Then, I scrutinise the nature and extent to which cultural factors may influence the phenomenology of the experience of certain events as traumatic and subsequent symptoms of post-traumatic stress. It seems that cultural circumstances (...) alter the way in which trauma is experienced; it is not clear whether there is in fact a core pathology of PTSD, as the DSM assumes, or whether the structure of the experience of trauma is too multifaceted to be summarised in one diagnostic category. Finally, I show that phenomenological enquiry promises to identify the structural similarities that would justify the delineation of a distinct diagnostic category. (shrink)

In their paper ‘Designing AI for mental health diagnosis: challenges from sub-Saharan African value-laden judgements on mental health disorders’, Ugar and Malele focused on the challenges and considerations surrounding the design and implementation of artificial intelligence (AI) and machine learning (ML) technologies for diagnosing mental health disorders in South Africa. Although the authors recognise the application of AI and ML in healthcare, they put forward the challenges, particularly in adopting Wakefield’s hybrid theory, where elements of naturalism and normativism are combined (...) in defining mental disorders. They argue that a generic or universally designed AI or ML would not be appropriate in countries with strong and varied local contexts. Hence, they believe that current and future AI developers should consider the cultural nuances, value systems and contextual factors in designing and implementing AI technologies for mental health diagnosis in Africa. When the authors argue that a universal definition of mental health may not be appropriate in Africa, we would like to offer something in contrast. If nomenclature like the Diagnostic and Statistical Manual of Mental Disorders (DSM) can be widely accepted, why does AI, which relies on these codes, encounter scepticism? Recognising the significant influence of culture on all aspects of patient care in psychiatry, the DSM-IV introduced the …. (shrink)

Ugar and Malele write that generic machine learning (ML) technologies for mental health diagnosis would be challenging to implement in sub-Saharan Africa due to cultural specificities in how those conditions are diagnosed. For example, they say that in South Africa, the appearance of ‘schizophrenia’ might be understood as a type of spiritual possession, rather than a mental disorder caused by a brain dysfunction. Hence, a generic ML system is likely to ‘misdiagnose’ persons whose symptomatology matches that of schizophrenia in (...) the South African context. The authors thus claim that ‘a generic or universal design cannot be effective given the heterogeneity of value judgements in defining what mental health disorders are in different contexts’.1 Should we take this to mean that ML systems ‘should not be designed with a generalised perception of mental disorders,’1 as the authors suggest? On the contrary, my view is that generic ML can be useful, with the caveat that issues of cultural sensitivity may engender translational challenges in various national and cultural contexts. Yet, if it can be demonstrated that a generic ML system can reliably and accurately pick up on shared symptomatologies across cultures despite what any individual or community might believe about their actual causes, this aspect is surely the function and value of diagnostic ML which we should take to matter. Cultural gaps in aetiological understandings of mental health conditions make it all the more important to advance generic ML as a calibrating diagnostic tool. In this commentary, therefore, I will endeavour to make a case for generic ML in mental healthcare. ### Aetiological (mis)understanding across cultures The fundamental complexity to which Ugar and Malele direct our attention is the fact that mental health conditions are attributed to variable causal explanations, rather than a …. (shrink)

The article concentrates on answering the main question to be addressed, as stated in its title: which psychology(ies) serves us best? In order to achieve this goal, we pursue possible answers in history of psychology of religion and its interdisciplinary relationships with its sister disciplines, anthropology of religion and religious studies, resulting with sketching a typology of the main attitudes towards conceptualising psycho-cultural interface, prevalent among psychologists: the Universalist, the Absolutist and the Relativist stances. Next chosen examples from the (...) field of applied psychology are presented, as the role of the cultural factor within the history of Diagnostic and Statistical Manual of Mental Disorders’ ( DSM) development is discussed alongside presenting research on the phenomenon of ‘hearing voices’, in order to show the marked way for the future – the importance of including the cultural factor in psychological research on religion. (shrink)

Few of the statements penned by philosophers have become as infamous as the “God is Dead!” of Friedrich Nietzsche. This study is not concerned with the reasons why this phrase is so popular. Instead, I would like to delve into the prehistory and partial genesis of the concept, something Nietzsche adopted from a previous tradition. Apart from known examples of theses on the death of God by Hegel, Schelling or Jean Paul, I will shed light on some of the confusion (...) surrounding the phrase deus est mortuus in Mediaeval Christian liturgical literature and mysticism, with roots reaching back to Neoplatonism. The goal of this study is to point out that this phrase about the death of God had no significant constitutive meaning for Nietzsche but was, instead, a relatively common literary and rhetorical topos among other culturally diagnostic expressive elements. Nietzsche used it as an illustrative shortcut when describing the intercultural processes of his time, with no ambition to originality, instead, with the clear intention of shaking up the (non)thought of the comfortable bureaucrats and legalistic petit bourgeois of Germany in the late 19th century. (shrink)

In this paper I will show how the medical image, presented to the patient by the physician, participates in medicine's cold culture of abstraction, objectification and mandated normativity. I begin by giving a brief account of the use of anatomical imaging since the Renaissance to show how images have historically functioned in contrast to how they are currently used in medical practice. Next, I examine how contemporary medical imaging techniques participate in a kind of knowledge production that objectifies the human (...) body. Finally, I elucidate how physicians ought to place the medical image within the context of the lived body so as to create a healing relationship with the patient. In all this I hope to show that the medical image, far from a piece of objective data, testifies to the interplay of particular beliefs, practices and doctrines contemporary medicine holds dear. To best treat her patient, the physician must appreciate the influence of these images and appropriately place them within the context of the patient's lived experience. (shrink)

A recent clinical literature on the psychology of cosmetic surgery patients is concerned with distinguishing good from bad candidates. Body Dysmorphic Disorder (BDD) — a mental disorder marked by a pathological aversion to some aspect(s) of one’s appearance — is typically understood in this context as a contra-indication for cosmetic surgery, as it marks those with inappropriate motivation who are unlikely to be satisfied by the surgery’s outcomes. This article uses Foucault’s genealogical work to argue that both the attempt to (...) provide diagnostic conditions for BDD itself, and the broader attempt to demarcate normal and psychopathological concern with appearance are, in part, effects of disciplinary power. Although often presented as a way of making cosmetic surgery more ethical and restrained, this epistemic project inadvertently defends cosmetic surgical interests. Specifically, it contributes to legitimizing the image of an ethically suspect sub-specialty of medicine, and supports its commercial expansion and effective profit-making by displacing its negative sequelae onto patient psyches. (shrink)

The present research is the first part of econometric study of the so called sponsored goods and looks at one of the most common types of such goods namely art products created by theaters, concert organizations and museums. The aim of the paper is to analyse the performance of Russian art organizations to find out to what extend the conditions of their functioning in post Soviet times under the development of market economy, democratization of leisure and changes in consumer preferences (...) influence their economic results. Could Russian theaters, museums and concert organizations be self- sufficient in market economy established in Russian in 1991-2010?The set up task determined the object of the study and the statistical data to be used-40 years time series performance indicators that include equal time intervals-1971-1990 for performing arts organizations and 1991-2010-for theaters, concert organizations and museums. The specifics of calculations presented in the article result from the very approach to the testing of cost disease. Its essence is to reveal the symptoms of this disease in art organizations taken as an element of economy as a whole rather than only as a part of cultural activities. Accordingly a new method of diagnostics of the cost disease is suggested that is based on development of specific indexes measuring the lag of labor productivity, advancing dynamics of wages and priority growth in prices for tickets in relation to the corresponding indexes of macroeconomic dynamics as well as determination of cost disease consequences-the deficit of income of providers of cultural goods. The implementation of such an approach allowed to construct three-dimensional space which coordinates describe the dynamics of performance results of art organizations. (shrink)

FROM POLITICS TO THE MARKETPLACE, FEAR PLAYS AN INCREASINGLY important role in American culture. It shapes decisions as well as character, while it feeds an "ethic of security" that raises personal and national safety to the status of highest good. How might Christians respond faithfully to a culture of fear? This essay draws on Thomas Aquinas' account of fear in the Summa Theologica to provide a set of analytical categories and diagnostic questions in hopes of helping us become more (...) reflective about fear. At the very least, this discussion seeks to reintroduce the premodern categories of ordered and disordered fear to challenge the modern presumption that fear is a pre-political "given" in its twin forms of anxiety and terror. (shrink)

Contemporary leadership theory -- Leading with heart -- Moses -- Gautama Buddha -- Confucius -- Jesus Christ -- Muhammad -- Mahatma Gandhi -- Martin Luther King, Jr. -- St. Pope John Paul II -- St. Mother Teresa -- Pope Francis I -- What have you learned -- Appendix: Diagnostics (Heart Smart surveys I & II).

Nietzsche says "good Europeans" must not only cultivate a "supra-national" view, but also "supra-European" perspective to transcend their European biases and see beyond the horizon of Western culture. The volume takes up such conceptual frontier crossings and syntheses. Emphasizing Nietzsche's genealogy of European culture and his reflections upon the constitution of Europe in the broadest sense, its essays examine peoples and nations, values and arts, knowledge and religion. Nietzsche's apprehensions about the crises of nihilism and decadence and their implications for (...) Europe's future are investigated in this context. Concerning the crossing of notional frontiers, contributors examine Nietzsche's hoped-for dismantling of Europe's state borders, the overcoming of national prejudices and rivalries, and the propagation of a revitalizing "supra-European" perspective on the continent, its culture and future. They also illuminate lines of syntheses, notably the syncretism of the ancient Greeks and its possible example for the European culture to-be. Finally certain of Europe's current problems are considered via the critical apparatus furnished by Nietzsche's philosophy and the diagnostic tools it provides. (shrink)

ABSTRACT This paper aims to offer both an interpretation and a critique of the epistemological foundations underlying one of the most recent approaches to trauma studies: cultural trauma theory. After the First World War, the founding father of psychoanalysis, Sigmund Freud, inquired into whether his diagnostic of “traumatic neurosis” could shed light on how collectives deal with unsettling experiences and memories. Throughout the intervening decades, Freud´s insights into collective trauma have attracted the interest of scholars from various disciplines (...) within the humanities and social sciences, from literary studies to historiography, memory studies, and, finally – the focus of this paper – cultural and social theory. By underlining the ways in which the proponents of cultural trauma theory – Jeffrey Alexander, Neil Smelzer, Piotr Sztompka, Bernhard Giesen, and Ron Eyerman – have reframed Freudian ideas regarding the transmission of legacies of collective suffering, the paper considers whether the notion of trauma can be extended to the analysis of cultures and societies. It explores the ambivalent relationship between psychoanalysis and contemporary cultural trauma theory to disclose the theoretical assumptions and weaknesses of the latter. (shrink)

The present paper will summarise the methodology, the scientific outcomes, and the potential for generalisation of the model of a project that studied cohabitation between human inhabitants and liminal species (in the present case, corvids) in Tartu, Estonia, from October 2021 to July 2023, with a comparative field study in Paris, France. It will present the context and goals of using a semiotic model to map interspecific cohabitation, expose what kind of data can be used to feed the model in (...) a relevant way and how it was done in the case of this project. This paper will present how the model diagnosed issues in cohabitation, both from material nuisances and cultural aspects, insisting on the concept of “hostile minority” that emerged from the study. It will discuss the importance of problem-solving in interspecific cohabitation, what the model suggested regarding this aspect, how this tool can be generalised to a large variety of cases and why it should be used this way. (shrink)

Within the still-dominant medical discourse on dementia, disorders of language feature prominently among diagnostic criteria. In this view, changes in ability to produce or understand coherent speech are considered to be an inevitable result of neuropathology. Alternative psychosocial accounts of communicative challenges in dementia exists, but to date, little emphasis has been placed on people with dementia as social actors who create meaning and context from their social interactions. In this article we draw on Bakhtin’s concepts of the carnivalesque, (...) heteroglossia, polyphony and dialogism to analyse a series of interactions involving people with dementia in day and residential care environments. We argue that many of the communicative challenges faced by people with dementia arise from the social environments in which they find themselves, and that the utterances of people with dementia in the face of these social challenges show many of the hallmarks of cultural resistance identified by Bakhtin. (shrink)

I present two philosophical arguments that Antisocial Personality Disorder (ASPD) and Psychopathy can be expected to be culturally variable. I argue that the ways in which people with ASPD and psychopaths can be expected to act will vary with societal values and culture. In the second part of the chapter, I will briefly review some of the empirical literature on cross-cultural variation in ASPD and psychopathy and argue that it is consistent with my philosophical claims. My conclusion in this (...) chapter is that methods of diagnosis will need to be culturally specific. A diagnostic instrument (such as the PCL-R or DSM) should not be uncritically employed in cultures that are very different from those in which it was initially developed. (shrink)

À partir d’une approche anthropologique des prises en charge médicales de la tuberculose et du paludisme, ainsi que des conceptions et usages de la prévention dans des milieux urbains d’Afrique de l’Ouest , ce texte interroge la nature du métier de soignant. Après nous être penchés sur les spécificités de ce type d’étude anthropologique en milieu médical, nous nous attachons à décrypter les processus d’occultations des singularités du malade qui caractérisent les messages et discours de prévention. Dans les structures de (...) santé, sont étudiées les négociations des normes de diagnostic et de traitement à l’œuvre ; les attitudes des soignants qui oscillent entre sur- et sous-estimations des risques sanitaires ; et le hiatus entre la demande et les besoins réels de formations continues. Enfin, nous nous penchons sur la rencontre entre les soignants et les malades qui peut se trouver transformée par les spécificités de la maladie et de son traitement. On constate alors que les fondements de la professionnalisation tendent à disparaître au profit d’un mode de régulation du rapport au malade, au collègue et plus largement au savoir médical qui témoigne de l’émergence d’une culture soignante qui est, de fait, une culture organisationnelle. Elle se caractérise à la fois par la délégation des tâches à des non-professionnels, la production et la résolution des conflits mettant en évidence des réseaux clientélistes ainsi que par une routinisation des gestes.Drawing on an anthropological approach of tuberculosis and malaria care in West African cities , and on an analysis of prevention modes, this paper examines the characteristics of medical work. We first examined the conditions of an anthropological field study in health care centres. The concealment of both patients’ singularities and populations’ specificities targeted in the prevention messages were then studied. The negotiation of diagnosis and treatment standards, and the under- and over-estimations of nosocomial risks were also analysed. We also focused on the gap between demands and actual needs for training, and on the relationships between health care providers and patients, which can be modified by the specificities of the disease. We noticed a decay of professionalization, a kind of regulation of relationships between health care workers and patients, and among medical staff, which expresses an emerging medical culture, which is also an organizational culture. Its main features are the delegation of tasks to non-professionals workers, a strategy of conflict management based on clientelism, and the development of routine action. (shrink)

Through present time we’re experiencing, as in intellectual discourse also in everyday language, one truly inflationary use of the notion of culture. If almost everything can be marked by the name of culture, then the notion and the object lose their diagnostic and analytical ground. This elaboration attempts – through the work of Max Weber and the recent philosophical anthropology – to explain that culture is one anthropologically founded, socially basic fact without whose involvement there is no possibility of (...) individual’s life nor is understandable history of development of people, nations and societies. In the background of such re-defining, regarding the understanding of culture, with their actuality, are certain questions, e.g.: clash of cultures ? Can there be any multicultural society? Is there a need among societies, peoples, nations for one “dominant culture” as a necessity for their survival? etc. (shrink)

The work of Professor Kraus is more than welcome at a time in which Psychopathology has become increasingly shallow and lacking in density, content with the role of an ideal “observer” whose only ambition is an objective description of signs and symptoms in order to fulfil operational criteria which reliably bestow a place for the case under observation within the grid of diagnostic classification.

This paper aims to show that the classification by the American Psychiatric Association in the Diagnostic and Statistical Manual of Mental Disorders of a distinct listing of disorders known as Culture-Bound Syndromes is misguided. I argue that the list of CBS comprises either genuine disorders that should be included within the main body of the DSM; or ersatz-disorders that serve a practical role for psychiatrists dealing with patients from certain cultures but will one day be eliminated or assimilated by (...) bona fide DSM classifications. In support of these views I draw on claims from two key themes in the philosophy of science: the claim that all folk explanations for phenomena are thoroughly theoretical and therefore fallible; and the occurrence of theoretical elimination in the history of science. I contend that any ersatz-disorders located in the DSM that are judged to be radically false do not differ in kind from eliminated theories in the history of pre-science. (shrink)

Many view cancellation as a method for holding influential personalities accountable for bad behavior, while others think cancelling amounts to censorship and bullying. I hold that neither of these accounts are worth pursuing, especially if the aim is social progress. In this paper, I offer a situated account of cancellation and cancel culture, locating the phenomenon in our exclusionary history while examining the social dynamics of belief. When we situate cancel culture, we can see how problematic instances of cancelling are (...) embedded in ignorance. While combatting ignorance appears to call for a remedy rooted in feminist standpoint epistemology, there are risks in adopting naive practices of deference. Applying criticisms of epistemic injustice and adopting Táíwò’s elite capture framework, I explain how well-intentioned cancelling can work against social movements. Since epistemic trust mechanisms discourage self-reflection and belief revision, the relevant tactics for enacting social change—coalition politics and education—seem out of reach. I conclude by sketching cancel culture as a diagnostic tool: cancellation can be used appropriately in marginalized communities, but when it comes to combatting ignorance among privileged folks, we should view cancel culture as a method for determining where our social institutions are failing us. (shrink)

This article works across multiple disciplinary boundaries, especially queer theory, to examine critically the controversial, and often socially controlling, role of biomedical knowledge and interventions in the realm of human sexuality. It will attempt to situate scientific/medical discourses on sexuality historically, socially, and culturally in order to expose the ways in which “proper” sexual health in medical research and clinical practice has been conflated with prevailing social norms at particular historical junctures in the 20th and 21st centuries. How might the (...) relationship between clinical and cultural spheres be better engaged in biomedical knowledge and clinical practice in understanding sexual health, given the impact of homophobic and transphobic assumptions in the diagnostic histories of homosexuality and Gender Identity Disorder in Childhood, a new diagnostic category introduced into the DSM following the removal of homosexuality from the DSM-III? The article will argue further that biomedical knowledge is always already mediated through culture by analyzing normative racial, gender, class, and sexual ideologies that regulated early understandings of the epidemiology of the HIV/AIDS pandemic in the West and in the postcolonial world while informing global health policy on HIV/AIDS. The article concludes by examining the implications of medical education for both LGBTQI patients and medical professionals, for understanding gender and sexual rights as human rights, and for thinking about new kinds of interventions, contestations, and struggles to resist continued homophobic and transphobic assumptions in biomedical practice today and their ongoing effects in the everyday world. (shrink)

This volume summarizes the ethical, social and cultural contexts of interfacing brains and computers. It is intended for the interdisciplinary community of BCI stakeholders. Insofar, engineers, neuroscientists, psychologists, physicians, care-givers and also users and their relatives are concerned. For about the last twenty years brain-computer-interfaces (BCIs) have been investigated with increasing intensity and have in principle shown their potential to be useful tools in diagnostics, rehabilitation and assistive technology. The central promise of BCI technology is enabling severely impaired people (...) in mobility, grasping, communication, and entertainment. Successful applications are for instance communication devices enabling locked-in patients in staying in contact with their environment, or prostheses enabling paralysed people in reaching and grasping. In addition to this, it serves as an introduction to the whole field of BCI for any interested reader. (shrink)

Since the appearance of the 1992 film Buffy, The Vampire Slayer (hereafter BtVS) and the popular 1997-2003 TV series based on it, Buffy has become a cult figure of global media culture with a panorama of websites, copious media and scholarly dissection, academic conferences, and a fandom that continues to devour reruns and DVDs of the 144 episodes. The series caught its moment and its audience, popularizing Buffyspeak, the Buffyverse (the textual universe of the show), and Buffypeople, who dedicated themselves (...) to promoting and explicating the phenomenon and exemplified the British cultural studies ideal of the active audience, able to both quote and interpret, while citing episode and season. A global popular, by the time the series reached its apocalyptic conclusion in summer 2003, it was widely recognized as one of the most striking cult TV shows of the epoch. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Philosophy, Psychiatry, & Psychology 10.1 (2003) 63-66 [Access article in PDF] The Pragmatics of Psychiatry and the Psychiatry of Cross-Cultural Suffering Jennifer Radden I AM IN SUBSTANTIAL AGREEMENT with many of the conclusions David Brendel draws in his thoughtful discussion. Misleading language aside, I particularly applaud his use of my plea for ontological descriptivism to support clinical practice, which respects, as he puts it, the subjectively "melancholic" person (...) living behind the objectively "depressed" clinical presentation.Brendel offers two main critiques of my discussion about the relationship between today's depression and melancholia of past eras. First, he asserts that I neglect the relevance of causal reasoning in my preference for a descriptivist over a causal ontology. Second, arguing that pragmatic considerations ought to be, as he says, front and center when philosophers and psychiatrists "grapple with the complexities of psychiatric explanation," (Brendel 2003, 54) he questions what he sees as my too ready dismissal of pragmatism in this discussion. Allegiance to pragmatism seems to me to sit strangely with support for a causal ontology, as I shall try to demonstrate. But first let me comment on these two sides of Brendel's commentary.The case of Van Gogh's alleged melancholia is particularly well chosen because there has been continuing debate about Van Gogh's condition, including scholarly work attributing it to an inherited metabolic disorder (Arnold 1992). Brendel's suggestion that a causal ontology might allow us to use historical evidence to throw light on the relation between depression and melancholia is an interesting and fruitful one that I had overlooked. Brendel also holds hope for drug cartography as a means of determining the causes of mental disorders. I admit to the initial plausibility of the approach to classification employed by drug cartography, of course. Diagnostic maps must be evaluated according to their effectiveness for the purposes they serve, and cannot—or should not—be seen as mere descriptions of natural phenomena. And maps based on psychopharmacological effects will serve one of the most important purposes we can have in relation to mental disorders: their successful treatment. Nonetheless, as I indicated in my essay, there are conceptual limitations to drug cartography. That several different syndromes respond to the same drug is suggestive, but it does not tell us anything definitive about structural similarities or differences between those different disorders. Nor, from the fact that a condition is alleviated by drugs, does it follow that a particular brain state was the initiating cause of that condition.My dismissal of a pragmatic approach in the foregoing discussion may have been overly hasty. [End Page 63] But in trying to make good this omission, I find myself struck by the complexity of the task. There appear to be at least five different places where a pragmatic response might be called for: (1) in deciding what to say about the relationship between depression and melancholia; (2) in determining the structure of any given psychiatric classification; (3) in choosing between what I have called descriptivist and causal ontologies; (4) in electing a course or method of treatment in the clinical context; and (5) in evaluating psychiatric explanations.With regard to (1), I have sketched in a note one pragmatic consideration in favor of equating melancholia and depression: by so doing, we might reinvest depressive states with some of the glamorous associations from the past and so diminish the stigma and provide some compensation and consolation for the suffering attaching to depression. Pragmatic reasoning may be perfectly appropriate here. I beg to point out that pragmatic considerations let me neglect it.With regard to (2), I recognize that psychiatric classifications are not so much identifications of natural kinds as responses to our various purposes; indeed, this point is offered as one drawback of adopting a causal analysis, because there is little reason to expect our purposes, which are a product of culture, to correspond to natural arrangements, which are not.With regard to (3), if there were overriding pragmatic considerations that favored accepting one or the other of these ontologies, then perhaps this would be... (shrink)

This paper argues that the diagnostic import of Adorno's culture industry writings lie in their psychoanalytically rooted claim that contemporary culture is losing its ability to negate and reconfigure experience, due to the modern subject's instrumentalized relationship to culture. Adorno uses psychoanalytic ideas—namely, modified and historicized versions of Freud's theory of the instincts, ego formation, the reality principle, and the superego—to show that changes in the social organization of the psyche, which track the transition from myth to enlightenment, put (...) the ego in a precarious position, torn between a primal fear of nature that drives it to submit to society, and internalized fear of its own internal nature, as well as of losing itself in society. This explains how culture becomes a resource capable of being mobilized by the ego's defense mechanisms of identification and introjection to shore up its own sense of solidity, thereby negating culture's potential for transcendence or transformation. This paper concludes with a coda that suggests that, while rejecting Adorno's metacritique of the reason is not sufficient grounds for rejecting the culture industry, critical theorists like Habermas and Honneth may have other tools at their disposal for contesting its conclusions. (shrink)

Walter Benjamin a suggéré de voir dans le fascisme une « esthétisation de la politique ». Avant lui, ce même diagnostic était appliqué non pas aux régimes autoritaires, mais, au contraire, aux régimes démocratiques. De Platon à Carl Schmitt, la philosophie a dénoncé la démocratie comme une multitude inconsistante et « bigarrée », qui préfère le jeu à l’ordre. Rebentisch estime que derrière ce jugement dépréciatif, les ennemis de la démocratie ont en fait parfaitement saisi quelques-uns de ses traits (...) distinctifs qu’il s’agit aujourd’hui de défendre dans une culture démocratique. La démocratie ne peut se passer de la mise en scène, car c’est sur scène qu’elle peut figurer le visage qu’elle veut se donner collectivement, consciente de l’écart qui subsiste toujours entre les identités actuelles et les identités possibles. (shrink)

The Papanicolaou (Pap) smear, also called the Pap test, cyto test, cervical smear or cervical cytology, has been described as the most widely used and established cancer-screening technology in the world. It has also been described as a very simple technology including a brush, a microscope slide, fi xative and cervical cells from women. In 1928, George N. Papanicolaou, a Medical Doctor, investigator, PhD in zoology and Aureli Babes (1928/1967), a Romanian pathologist, each independently claimed to have found a ‘very (...) simple’ technique, which provided a new possibility for early diagnostics of cancer/malignant tumours in the female genital tract/uterine cervix. The technique was subsequently named after Papanicolaou who, according to Wied (1964: 174), was more successful than Babes in ‘stimulating the introduction of mass screening projects which are the actual benefi t of the method’. (shrink)

Medical semiotics, as a branch of general semiotics, has never really gained a foothold in either semiotics itself or medical science, despite the fact that the discipline of semiotics traces its roots to the medical domain in the ancient world and especially to Hippocrates. With several key exceptions, such as Jakob von Uexküll in 1909 and in the 1990s with Thomas A. Sebeok, there is no evidence that medical semiotics is a significant and growing area of research either within semiotics (...) or medical practice. The purpose of this book is to revive interest in this field examining the historical and epistemological principles that would make it highly relevant today in the global village where conceptions of disease and health are in constant flux. The book is written it in a non-technical way-that is, no assumptions are made on the part of the reader of technical semiotics. Our hope is that this book will bring out the importance of semiotics to the practice of medicine. It can be considered to be a textbook in the field of medical semiotics, constituting to the best of our knowledge the first of its kind. (shrink)

According to a chorus of authors, the human life-world is currently invaded by an avalanche of high-tech devices referred to as “emerging,” ”intimate,” or ”NBIC” technologies: a new type of contrivances or gadgets designed to optimize cognitive or sensory performance and / or to enable mood management. Rather than manipulating objects in the outside world, they are designed to influence human bodies and brains more directly, and on a molecular scale. In this paper, these devices will be framed as ‘extimate’ (...) technologies (both intimate and external; both embedded and foreign; both life-enhancing and intrusive), a concept borrowed from Jacques Lacan. Although Lacan is not commonly regarded as a philosopher of technology, the dialectical relationship between human desire and technological artefacts runs as an important thread through his work. Moreover, he was remarkably prescient concerning the blending of life science and computer science, which is such a distinctive feature of the current techno-scientific turn. Building on a series of Lacanian concepts, my aim is to develop a psychoanalytical diagnostic of the technological present. Finally, I will indicate how such an analysis may inform our understanding of human life and embodiment as such. (shrink)

There are two big problems related to leadership today: unequal representation and high failure rates among leaders. This conceptual paper argues that commonly shared values, assumptions, and beliefs about leadership, i.e., universal leadership culture, are the common cause of both problems. After the concepts and levels related to leadership culture were explained, we introduce a multilevel, multi-actor process model named the bottleneck metaphor of leadership culture. This metaphor describes how leadership cultures are co-constructed by multiple actors based on their involvement (...) in leader selection and reproduce themselves in groups over time based on emergent leaders' characteristics. Next, a diagnostic tool called “the leadership mirror” is proposed for organizations that want to assess their leadership culture's current state as a starting point for further interventions. Specific suggestions are made for various actors, ranging from individuals to organizations, for their possible roles in preventing undesired leadership cultures. (shrink)

It is important to note that certain mental health disorders are classified as rare conditions, and they have their own ‘cultural concepts of distress’ as defined in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM 5). Cultural concepts of distress are a recent attempt to understand psychological distress influenced by culture, separate from biomedical diagnoses that require equal attention and support for individuals and their families, both physically and emotionally. [1].

As digital technologies are integrated into medical environments, they continue to transform the experience of contemporary health care. Importantly, medicine is increasingly visual. In the history of sonography, visibility has played an important role in accessing fetal bodies for diagnostic and entertainment purposes. With the advent of three-dimensional rendering, sonography presents the fetus visually as already a child. The aesthetics of this process and the resulting imagery, made possible in digital networks, discloses important changes in the relationship between technology (...) and biology, reproductive health and political debates, and biotechnology and culture. (shrink)

The theme of the philosopher as therapist dominates Nietzsche's entire opus, from his earliest writings to the Zarathustra period and beyond. Nietzsche wishes to hasten the coming and future sanctification of a new type of synthetic human being, and his entire teaching is shaped by his own struggles against illness.Yet few Nietzsche scholars have paid this crucial therapeutic element of his thought sufficient attention. This collection of essays by leading scholars in the field is composed around the Nietzschean insight, which (...) has its roots in the Hippocratic tradition of ancient medicine, that beliefs, behaviours, ideals and patterns of striving are not things for which individuals or even cultures are responsible. Rather, they are symptoms of what an individual or culture is, which symptoms require diagnostic interpretation and evaluation. The book identifies three principal approaches in Nietzsche's philosophy: diagnostic, prognostic and therapeutic. Each essay takes up this essential insight into Nietzsche's therapeutic philosophy from a different perspective and collectively they reveal an array of insightful approaches to self-induced enhancement, for both individuals and cultures. (shrink)

The Concussion in Sport Group guidelines have successfully brought the attention of brain injuries to the global medical and sport research communities, and has significantly impacted brain injury-related practices and rules of international sport. Despite being the global repository of state-of-the-art science, diagnostic tools and guides to clinical practice, the ensuing consensus statements remain the object of ethical and sociocultural criticism. The purpose of this paper is to bring to bear a broad range of multidisciplinary challenges to the processes (...) and products of sport-related concussion movement. We identify lacunae in scientific research and clinical guidance in relation to age, disability, gender and race. We also identify, through multidisciplinary and interdisciplinary analysis, a range of ethical problems resulting from conflicts of interest, processes of attributing expertise in sport-related concussion, unjustifiably narrow methodological control and insufficient athlete engagement in research and policy development. We argue that the sport and exercise medicine community need to augment the existing research and practice foci to understand these problems more holistically and, in turn, provide guidance and recommendations that help sport clinicians better care for brain-injured athletes. (shrink)

The ‘multicultural clinical interaction’ presents itself as a dilemma for the mental health practitioner. Literature describes two problematic areas where this issues emerges - how to make an adequate distinction between religious rituals and the rituals that may be symptomatic of ‘obsessive compulsive disorder’ (OCD), and how to differentiate ‘normative’ religious or spiritual beliefs, behaviours, and experiences from ‘psychotic’ illnesses. When it comes to understanding service user’s ‘idioms of distress’, beliefs about how culture influences behaviour can create considerable confusion and (...) ‘normative uncertainty’ for mental health practitioners. In the absence of clear diagnostic and assessment criteria on distinguishing between ‘culture’ and ‘psychopathology’, practitioners have had to rely on their own intuition and seek out possible ‘strategies’ or ‘procedures’ from a contradictory and cross-disciplinary evidence base. Decontextualisation of service users’ experiences may result in the pathologisation of culturally ‘normative’ phenomenon, ‘category fallacy’ errors, and poor health care experiences and outcomes for service users. This paper situates this dilemma within a wider debate that has concerned both the biomedical and social sciences, namely, the unresolved question of ‘normality’ or ‘abnormality’. Indeed, issues that arise from dilemmas surrounding the question of ‘culture’ or ‘psychopathology’ are intimately tied to wider cultural ideas about what is considered ‘normal’. The disciplines of psychiatry, psychology, and medical anthropology have struggled to establish workable criteria against which to judge behaviour as ‘normal’, ‘abnormal’, or ‘pathological’. Three models for understanding mental ‘abnormality’ are evident in ‘transcultural psychiatry’ (what is now commonly known as ‘cultural psychiatry’), and these models have corresponded closely to the interpretive models used by anthropologists attempting to make sense of the apparent diversity of human societies. The three models of ‘absolutism’, ‘universalism’ and ‘cultural relativism’ have not only important consequences for the nature and conduct of research enquiry, but also have implications for how the dilemma of ‘culture’ or ‘psychopathology’ is attended to in clinical practice. (shrink)