Culture-bound syndromes in Aboriginal Australian populations

Abstract

ABSTRACT Objective: This paper describes the validation of culture-bound syndromes with Urban (N=34) and Rural (N=31) Aboriginal participants. While culture bound syndromes have long been discussed in the international literature (see Cuellar & Paniagua, 2000), published empirical research with Aboriginal Australian populations remains absent. Critically, the secret nature of Aboriginal cultural practices presents additional research challenges which arguably do not impact to the same extent in other Indigenous cultures. The impacts on ensuring culturally and clinically competent assessment in the context of escalating rates of Indigenous suicide and mental health are significant. Method: Thematic analysis occurred with data generated from three phases of focus groups to address study objectives. The final stage involved a critical analysis of the DSM-IV Outline for Cultural Formulation (“OCF”) for the Aboriginal Australian context. Results: Validation of seven culture bound syndromes with predominant symptom consistency across locations is presented as well as determination of the cultural triggers implicated in the development of culture bound syndromes. Finally, an adaptation of the OCF is proposed to enable clinicians to undertake clinically and culturally valid assessment of Aboriginal clients. Conclusions: Practitioners are provided with guidance in the identification and formulation of culture-bound syndromes with Aboriginal Australian clients. KEY POINTS What is already known about this topic: (1) Anecdotal evidence of the existence of culture bound syndromes has been cited in a small number of papers. (2) Culture bound syndromes have long been discussed in the international literature. (3) DSM-IV Outline for Cultural Formulation (“OCF”) ensures guidance for practitioners around the formulation of culture bound syndromes. What this topic adds: (1) Empirically validates the existence of culture bound syndromes with Aboriginal Australian populations for the first time. (2) Validates symptom consistency across urban and rural Aboriginal Australian environments. (3) Provides practitioners with guidance regarding the formulation of assessment with Aboriginal clients experiencing culture bound syndromes.