Understanding Psychological Disorders: The Neuropsychosocial Approach 65
group. Research indicates that being a victim of childhood bullying can contrib-
ute to psychological problems in childhood and adulthood (Arseneault et al., 2008;
Fosse & Holen, 2004; Kumpulainen et al., 1998), and it is particularly likely to
lead to internalizing problems. (Bullying itself is one type of externalizing problem;
Kaltiala-Heino et al., 2000; Kumpulainen et al., 1998.)
War
War often infl icts extreme and prolonged stress on soldiers and civilian victims.
How an individual responds to the effects of war is determined by a variety of fac-
tors (discussed at length in Chapter 7), such as proximity to the fi ghting and the
duration of combat. Since the mandated extended tours of duty for American sol-
diers in Iraq and Afghanistan, approximately 20% of returning troops have symp-
toms of posttraumatic stress disorder or depression (Tanielian & Jaycox, 2008).
Culture
Every culture promotes an ideal of healthy functioning—
of a “normal” personality—and a notion of unhealthy
functioning. These ideals differ somewhat from culture to
culture and can shift over time (Doerfel-Baasen & Rauh,
2001). Some cultures, such as those of many Asian, Latin
American, and Middle Eastern countries, are collectivist,
placing a high value on getting along with others; in such
cultures, the goals of the group (family or community) tra-
ditionally take precedence over those of the individual. In
contrast, other cultures, such as those of Australia, Canada,
the United Kingdom, and the United States, are individual-
ist, valuing independence and autonomy; the goals of the in-
dividual take precedence over the goals of the group (Hui &
Triandis, 1986). In either case, if an individual has personal-
ity traits that are different from those valued by the culture,
other people’s responses to the person may lead him or her
to feel humiliated and to develop poor self-esteem, which
increases the risk of developing psychological disorders.
Culture Can Suppress or Facilitate Behaviors
Theproblem suppression-facilitation model (Weisz et al., 1987) addresses how cul-
ture can infl uence mental health and mental illness. According to the model, cultural
factors—such as values, social norms, and accepted child-rearing practices—can af-
fect a child’s behavior by minimizing or amplifying the child’s natural behavioral
tendencies. Consider a child who has a tendency to be very energetic and active.
Cultures such as that of China, which value the ability to sit still for long periods
of time, seek to minimize such a behavioral tendency. Hong Kong schools require
children to sit and focus on schoolwork for long periods of time, and the children
are not allowed to leave their seats. From an early age, then, energetic and active
children must learn how to control their behavioral tendencies. This contrasts with
American culture, where the school day is organized to allow children in primary
grades to move around the classroom frequently (Sandberg, 2002).
Acculturation
Moving from one culture to another often leads people to adopt the values and be-
haviors of the new culture, a process that is termed acculturation. This can be very
stressful and can create tension between parents—who moved to the new culture as
adults—and their children, whose formative years were spent in the new culture. As
these children grow up, they may be forced to choose between the values and views
of their parents’ culture and those of the new culture, which can be stressful and can
make them more likely to develop psychological disorders (Escobar, Nervi, & Gara,
Collectivist cultures tend to emphasize getting
along with others and rank the community’s
well-being over the individual’s; these values
are reversed in individualist cultures. Individu-
als whose personalities differ from their culture’s
ideal may face humiliation and even discrimi-
nation and may come to see themselves in a
negative light—all of which can make them more
vulnerable to psychological disorders.Cancan Chu/Getty Images