Cultural factors considered in selected diagnostic criteria and interview schedules.

Abstract

Researchers have argued that diagnostic criteria and interview schedules inadequately reflect cultural influences in the definition and expression of psychopathology. In this study 11 widely used diagnostic criteria and interview schedules for schizophrenia, affective disorders, and personality disorders were examined to assess the extent to which they refer to cultural factors. The results indicated that 8 of 11 instruments referred to cultural influences in psychopathology at least once. The consideration of cultural factors, however, was primarily limited to the identification of delusions and hallucinations in schizophrenia. Very few cultural references were made in the diagnostic instruments of affective and personality disorders. The clinical implications of these findings are discussed with respect to the evaluation of cultural minority group members residing in the United States. Specific recommendations are offered to increase the attention given to culture in diagnostic instruments and to increase our understanding of how culture influences psychopathology. This study assesses the extent to which frequently used diagnostic criteria and interview schedules consider cultural factors in the identification of schizophrenic, affective, and personality disorders. Although some authors have discussed how selected diagnostic instruments fail to address cultural influences (Alarcon, 1983; Egeland, Hostetter, & Eshleman, 1983; Klerman, Vaillant, Spitzer, & Michaels, 1984; Swartz, Ben-Arie, & Teggin, 1985), none have systematically looked at the extent to which a wide range of diagnostic instruments address the role of culture in psychopathology. Such an examination should reflect the relative importance given to culture in the classification of mental disorders.