Discuss cultural and ethical considerations in diagnosis

In abnormal psychology, psychologists are faced with a hard task of diagnosing

patients with mental disorders. It is very difficult to define a mental disorder and to diagnose

a patient as it is dependent on the symptoms that patients report and show. These symptoms

can be behavioural, cognitive, physical or mood based. By using these symptoms

psychologist was able to make manuals that would help them make an easier diagnosis and

give suitable treatments to the patient. However, as the symptoms are dependent on patient’s

report, these manuals are often changed and adjusted. Currently psychologist,t mostly use

DSM V and/or ICD 10.

Currently using the manuals is the most spread technique for diagnosis, as it is

statistical and quantifiable. It is based on symptoms that define a disorder, for which

psychologist then can give an appropriate treatment. It is the most objective and generalised

method out of them all for diagnosing abnormality ty in behaviour.

However, this is where problems can arise. Mental disorders should not be viewed as

objective and manuals cannot be generalised to all cultures. Human behaviour is one part

dependent on the culture they grew up in. This is why there is a phenomenon known as

culture e-bound syndrome. These are disorders specific to a certain culture. For example,

depression is commonly present in the west, while this is not the case in Asia. One of the

possible explanations would be that Chinese culture is more of a collective society, therefore

people are provided with more social support than in an individualistic society like many

western countries are. Still, Rack (1982) considered, based on reports from Asian

psychologists, that it is not common in Asia to come to the doctor for emotional and mental

stress, and that is the reason that it is thought that depression is not as present.
 Additionally, different cultures have different behavioural norms and expectations.

This is why sometimes some mental disorders might be viewed differently in different

countries, as well as being reported differently. A good example is a study done by Binitie on

view of Schizophrenia in Nigerian culture. The aim was to investigate if there is the

difference in defining normality and abnormality in cultures. Participants were Nigerians who

are living in a city, and they were presented with information about schizophrenic patients.

Results showed that most of the participants could conclude that the patients were mentally

unwell, while 30 percent of participants reacted aggressively towards the patients. The study

shows how there are different norms between cultures regarding normal and abnormal

behaviour, that abnormality is subjective, and how culture can greatly affect the way we

perceive normality. Therefore it is very important to have a conscious approach when trying

to diagnose abnormal behaviour, and that culture needs to be taken into consideration. This is

taken into consideration in past decades, and therefore more diagnostic manuals are made that

are specific to certain cultures, such as CCMD.

Another problem raises with a diagnosis of abnormal behaviours, and it is of an

ethical nature. The main problem that should be considered when making a diagnosis is

labeling. Szasz (1967) pointed out that people are labeled with unwanted labels in order to be

excluded and isolated from the society. By diagnosing a patient with a mental disorder they

are given a label, which is, depending on a culture, often viewed as a negative. This may

cause the isloation of that person from the society or worsen their wellbeing. Additionally, as

the label of a mental disorder carries certain expected behaviours with it, the patient might

start to show these behaviours even though they were not previously present. It is possible

that if the patient was falsely diagnosed with a mental disorder, they would actually develop

it if labeled, due to the expectations that come with the label. This theory is called Scheff’s

labeling theory. This raises a question of when is it necessary to give a diagnosis to the
patient, and when is it actually helpful and when is it not, further making the diagnosis of

abnormality a difficult task.

To conclude, giving a diagnosis of abnormal behaviour is a very difficult task that

psychologists face. When doing so they additionally need to be conscious of the cultural

considerations as the abnormality is subjective cross cultures, and to the ethical

considerations as giving a diagnosis can sometimes worsen the well-being of a patient.